Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany.
Arch Gynecol Obstet. 2020 May;301(5):1267-1274. doi: 10.1007/s00404-020-05529-y. Epub 2020 Apr 10.
Although thrombocytosis in patients with primary ovarian cancer has been widely investigated, there are only very few data about the role of thrombocytosis in recurrent ovarian cancer. The aim of our study was to investigate the impact of pretreatment thrombocytosis prior to chemotherapy on clinical outcome in patients with recurrent platinum eligible ovarian cancer.
In our retrospective analysis we included 300 patients who were treated by AGO Study Group Centers within three prospective, randomized phase-III-trials. All patients included had been treatment-free for at least 6 months after platinum-based chemotherapy. We excluded patients who underwent secondary cytoreductive surgery before randomization to the trial. Thrombocytosis was defined as a platelet count of ≥ 400⋅10/L.
Pretreatment thrombocytosis was present in 37 out of 300 (12.3%) patients. Patients with thrombocytosis responded statistically significantly less to chemotherapy (overall response rate 35.3% and 41.6%, P = 0.046). The median progression-free survival (PFS) for patients with thrombocytosis was 6.36 months compared to 9.00 months for patients without thrombocytosis (hazard ratio [HR] = 1.19, 95% confidence interval [CI] = 0.84-1.69, P = 0.336). Median overall survival (OS) of patients with thrombocytosis was 16.33 months compared to 23.92 months of patients with a normal platelet count (HR = 1.46, 95% CI = 1.00-2.14, P = 0.047).
The present analysis suggests that pretreatment thrombocytosis is associated with unfavorable outcome with regard to response to chemotherapy and overall survival in recurrent ovarian cancer.
尽管原发性卵巢癌患者的血小板增多已得到广泛研究，但关于血小板增多在复发性卵巢癌中的作用的数据却很少。我们的研究目的是探讨化疗前血小板增多对复发性铂类敏感卵巢癌患者临床结局的影响。
在我们的回顾性分析中，我们纳入了 300 名在 AGO 研究组中心接受治疗的患者，这些患者参与了三项前瞻性、随机 III 期临床试验。所有纳入的患者在铂类化疗后均至少有 6 个月的无治疗期。我们排除了在随机分组前接受二次细胞减灭术的患者。血小板增多定义为血小板计数≥400×10/L。
300 名患者中有 37 名（12.3%）存在化疗前血小板增多。血小板增多的患者对化疗的反应显著降低（总缓解率为 35.3%和 41.6%，P=0.046）。血小板增多患者的中位无进展生存期（PFS）为 6.36 个月，而无血小板增多患者的中位 PFS 为 9.00 个月（风险比 [HR] = 1.19，95%置信区间 [CI] = 0.84-1.69，P=0.336）。血小板增多患者的中位总生存期（OS）为 16.33 个月，而血小板计数正常患者的中位 OS 为 23.92 个月（HR = 1.46，95%CI = 1.00-2.14，P=0.047）。
本分析表明，化疗前血小板增多与复发性卵巢癌患者的化疗反应和总生存不良相关。
