Hefler-Frischmuth Katrin, Grimm Christoph, Gensthaler Lisa, Reiser Elisabeth, Schwameis Richard, Hefler Lukas A
Department of Internal Medicine I, Ordensklinikum Linz GmbH Barmherzige Schwestern, Seilerstätte 4, 4010, Linz, Austria.
Department of General Gynecology and Gynecologic Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Wien Klin Wochenschr. 2018 Oct;130(19-20):575-580. doi: 10.1007/s00508-018-1388-y. Epub 2018 Sep 3.
Preoperative hyponatremia and thrombocytosis are associated with perioperative morbidity in patients with epithelial ovarian cancer (EOC). The aim of the present study was to evaluate preoperative hyponatremia and thrombocytosis as prognostic parameters in patients with EOC.
In a retrospective cohort study, serum levels of sodium and thrombocyte counts were evaluated in 498 patients with EOC. Data were extracted from the prospectively maintained database. Results were correlated with clinicopathological parameters and patient survival.
Mean (standard deviation) overall pretherapeutic serum sodium levels and thrombocyte counts in patients with EOC were 138.8 (2.9) mmol/l and 340.1 (122.6) × 10/µl, respectively. Hyponatremia (serum sodium levels ≤ 134 mmol/l) was found in 33 (6.7%) patients and thrombocytosis (thrombocytes ≥ 450/µl) in 88 (17.7%) patients. Serum sodium levels were associated with the presence or absence of residual tumor tissue after primary surgery. Thrombocyte counts were associated with Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) tumor stage, presence/absence of residual tumor, histological grade and histological type. Patients with thrombocytosis presented with advanced tumor stage, a higher rate of postoperative residual tumor mass, higher tumor grade, and a higher rate of serous ovarian cancer. In a multivariate logistic regression analysis, only the established clinicopathological parameters but not serum sodium and thrombocyte count were independent predictors of patient overall survival.
Preoperative hyponatremia and thrombocytosis are not useful as additional independent prognostic parameters in patients with EOC.
术前低钠血症和血小板增多症与上皮性卵巢癌（EOC）患者的围手术期发病率相关。本研究的目的是评估术前低钠血症和血小板增多症作为EOC患者的预后参数。
在一项回顾性队列研究中，对498例EOC患者的血清钠水平和血小板计数进行了评估。数据从前瞻性维护的数据库中提取。结果与临床病理参数和患者生存率相关。
EOC患者治疗前血清钠水平和血小板计数的平均值（标准差）分别为138.8（2.9）mmol/L和340.1（122.6）×10⁹/μL。33例（6.7%）患者存在低钠血症（血清钠水平≤134 mmol/L），88例（17.7%）患者存在血小板增多症（血小板≥450×10⁹/μL）。血清钠水平与初次手术后残留肿瘤组织的有无相关。血小板计数与国际妇产科联盟（FIGO）肿瘤分期、残留肿瘤的有无、组织学分级和组织学类型相关。血小板增多症患者表现为肿瘤分期较晚、术后残留肿瘤肿块发生率较高、肿瘤分级较高以及浆液性卵巢癌发生率较高。在多因素逻辑回归分析中，只有既定的临床病理参数而非血清钠和血小板计数是患者总生存的独立预测因素。
术前低钠血症和血小板增多症作为EOC患者额外的独立预后参数并无用处。
