Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Gynecol Oncol. 2011 Aug;122(2):238-41. doi: 10.1016/j.ygyno.2011.04.012. Epub 2011 May 4.
To evaluate the impact of both pretreatment thrombocytosis, and platelet count reduction post-adjuvant chemotherapy, on survival in patients with advanced epithelial ovarian cancer.
Records of 179 women who underwent cytoreductive surgery for FIGO stage III or IV epithelial ovarian cancer and received six cycles of platinum/paclitaxel-based chemotherapy between July 1998 and March 2009 were retrospectively reviewed. Platelet ratio was defined as the preoperative platelet count divided by the platelet count after chemotherapy. The prognostic significance of thrombocytosis and platelet ratio, together with various clinicopathological factors, were evaluated by multivariate analysis.
Sixty-two of 179 (34.6%) patients had thrombocytosis at primary diagnosis. Patients with preoperative thrombocytosis had greater elevations of CA-125 (p<0.0001) and a greater volume of ascites (p=0.007). On multivariate analysis, thrombocytosis and CA-125 elevation retained significance as indicators of poor prognosis in patients with stage III or IV disease. In patients with normal CA-125 after chemotherapy, a high platelet ratio was an independent risk factor for reduced survival (p=0.05).
Preoperative thrombocytosis and a high platelet ratio appear to be poor prognostic factors of survival in patients with advanced epithelial ovarian cancer who were treated with cytoreductive surgery and adjuvant platinum/paclitaxel-based chemotherapy.
评估术前血小板增多和辅助化疗后血小板计数减少对晚期上皮性卵巢癌患者生存的影响。
回顾性分析了 1998 年 7 月至 2009 年 3 月期间接受细胞减灭术治疗 FIGO 分期 III 或 IV 上皮性卵巢癌并接受六周期铂类/紫杉醇为基础化疗的 179 例女性患者的记录。血小板比定义为术前血小板计数除以化疗后血小板计数。通过多变量分析评估血小板增多和血小板比与各种临床病理因素一起的预后意义。
179 例患者中有 62 例（34.6%）在初诊时出现血小板增多。术前血小板增多的患者 CA-125 升高更大（p<0.0001），腹水体积更大（p=0.007）。多变量分析显示，血小板增多和 CA-125 升高仍然是 III 或 IV 期疾病患者预后不良的指标。在化疗后 CA-125 正常的患者中，高血小板比是生存时间缩短的独立危险因素（p=0.05）。
术前血小板增多和高血小板比似乎是接受细胞减灭术和辅助铂类/紫杉醇为基础化疗的晚期上皮性卵巢癌患者生存的不良预后因素。
