Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan.
J Ovarian Res. 2020 May 6;13(1):55. doi: 10.1186/s13048-020-00651-6.
Thrombocytosis is related to tumor stage and survival in ovarian cancer in addition to the common complications of malignant diseases, such as anemia and inflammation. The aim of our study was to clarify the precise prognostic impact of pretreatment thrombocytosis in epithelial ovarian cancer.
We retrospectively analyzed 280 consecutive patients who were treated for epithelial ovarian cancer at our institution between 2001 and 2011.
Pretreatment thrombocytosis was observed in 18.9% of all patients and was associated with advanced FIGO stage, primary treatment, operation achievement, histologic subtype, microcytic hypochromic anemia (MHA), and nonmalignant inflammatory condition (P = 0.0018, 0.0028, 0.00050, 0.034, 0.00090 and 0.0022). In the patients who relapsed after primary adjuvant chemotherapy (n = 126), thrombocytosis was associated with a shorter treatment-free interval (TFI) (P = 0.0091). The univariate and multivariate analyses revealed that thrombocytosis was independently associated with TFI and MHA (P = 0.021 and 0.0091). Patients with thrombocytosis had worse progression-free survival (PFS) and overall survival (OS) than those without thrombocytosis (P < 0.0001 and < 0.0001). The multivariate analyses for prognostic factors demonstrated that thrombocytosis was significant for poor PFS and OS (P = 0.0050 and 0.022) independent of stage, histology, primary treatment, operation achievement, nonmalignant inflammatory condition and MHA.
The current findings indicate that the detrimental survival impact of pretreatment thrombocytosis in epithelial ovarian cancer may be independent of tumor extent but rather attributed to chemoresistance, further supporting the therapeutic potential of targeting thrombopoietic cytokines in the disease.
除了贫血和炎症等恶性疾病的常见并发症外，血小板增多症与卵巢癌的肿瘤分期和生存相关。我们研究的目的是阐明预处理血小板增多症对上皮性卵巢癌的确切预后影响。
我们回顾性分析了 2001 年至 2011 年间在我院治疗的 280 例上皮性卵巢癌连续患者。
所有患者中，预处理血小板增多症的发生率为 18.9%，与 FIGO 晚期、初次治疗、手术效果、组织学亚型、小细胞低色素性贫血（MHA）和非恶性炎症状态有关（P = 0.0018，0.0028，0.00050，0.034，0.00090 和 0.0022）。在初次辅助化疗后复发的患者（n = 126）中，血小板增多症与无治疗间隔时间（TFI）缩短相关（P = 0.0091）。单因素和多因素分析表明，血小板增多症与 TFI 和 MHA 独立相关（P = 0.021 和 0.0091）。血小板增多症患者的无进展生存期（PFS）和总生存期（OS）较无血小板增多症患者差（P < 0.0001 和 < 0.0001）。预后因素的多因素分析表明，血小板增多症与不良 PFS 和 OS 相关（P = 0.0050 和 0.022），与分期、组织学、初次治疗、手术效果、非恶性炎症状态和 MHA无关。
目前的研究结果表明，上皮性卵巢癌预处理血小板增多症对生存的不利影响可能与肿瘤范围无关，而是归因于化疗耐药性，进一步支持了在该疾病中靶向血小板生成细胞因子的治疗潜力。
