The prognostic significance of thrombocytosis in epithelial ovarian carcinoma

• Published in: Gynecologic oncology 2004, Vol.92 (1), p.211-214
• Main Authors: Li, Andrew J, Madden, Alison C, Cass, Ilana, Leuchter, Ronald S, Lagasse, Leo D, Karlan, Beth Y
• Format: Article
• Language: English
• Subjects: Disease-Free Survival; Female; Humans; Middle Aged; Neoplasm Staging; Ovarian carcinoma; Ovarian Neoplasms - blood; Ovarian Neoplasms - complications; Ovarian Neoplasms - pathology; Peritoneal carcinoma; Thrombocytosis; Thrombocytosis - complications
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2003.09.002

Objective. The objective of this study was to determine the incidence of thrombocytosis in epithelial ovarian carcinoma and examine associations with clinico-pathologic features. Thrombocytosis (platelet counts >400 × 10 9/l) has been identified as a poor prognostic factor in many cancers. Platelet-secreted factors may contribute to metastasis, invasion, and primary tumor growth. Methods. One hundred eighty-three patients with invasive epithelial ovarian or primary peritoneal carcinomas were identified between January 1996 and December 2000. Records were retrospectively reviewed and data analyzed using χ 2, Student's t test, and Cox proportional hazards model; survival was analyzed by the method of Kaplan and Meier. Results. Forty-one of 183 (22.4%) patients had thrombocytosis at primary diagnosis. Patients with preoperative thrombocytosis were found to have greater elevations of CA-125 ( P = 0.026), more advanced stage disease ( P = 0.016), higher grade tumors ( P = 0.010), more frequent lymph node metastases ( P = 0.018), and greater volume of ascites ( P < 0.0001). One hundred sixty of 183 (87.4%) patients achieved optimal cytoreduction; patients with thrombocytosis demonstrated a greater likelihood of suboptimal resection (residual disease >1 cm; 19/41 vs. 4/142 in patients without thrombocytosis, P < 0.0001). Patients with thrombocytosis had a shorter disease-free interval (12 vs. 34 months, P < 0.0001) and overall survival (28 vs. 79 months, P < 0.0001). On multivariate analysis, thrombocytosis retained significance as a poor prognostic indicator in patients with stage III and IVA disease ( P = 0.04). Conclusions. Thrombocytosis is a frequent preoperative finding in ovarian and peritoneal carcinomas and may be a marker of aggressive tumor biology.