Kim Myeong-Seon, Baek Seung Hun, Noh Joseph J, Shim Jung In, Kang Jun Hyeok, Jeong Soo Young, Choi Chel Hun, Kim Tae-Joong, Lee Jeong-Won, Lee Yoo-Young
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Front Oncol. 2022 Sep 8;12:926878. doi: 10.3389/fonc.2022.926878. eCollection 2022.
We investigated the incidence of reactive thrombocytosis after maximal cytoreductive surgery in advanced epithelial ovarian cancer (EOC) and its role in patient survival. We retrospectively reviewed the electronic medical records of patients who underwent primary cytoreductive surgery for advanced EOC from 1 January 2012 to 31 December 2017. We analyzed the serum platelet counts at various time points from before surgery, during the peri-operative period, and after each cycle of adjuvant chemotherapy. A total of 474 patients were eligible for the analysis. Among them, 401 patients (84.6%) had FIGO stage III disease status. The most common histology type was serous adenocarcinoma (405 patients, 85.4%). Seventy-nine patients (22.6%) received splenectomy, and optimal cytoreduction was achieved in 326 patients (68.8%). A week after surgery, thrombocytosis was observed in 165 patients (34.8%) in the entire cohort. Higher platelet counts were observed in patients with splenectomy compared with patients without splenectomy. In particular, thrombocytosis on the fifth cycle of adjuvant chemotherapy showed the most significant effects on overall survival in multivariate analysis. In a logistic regression model, splenectomy was significantly attributed to thrombocytosis on the fifth cycle of chemotherapy. Reactive thrombocytosis after primary cytoreductive surgery is associated with poor survival in advanced EOC, particularly when thrombocytosis is observed during adjuvant chemotherapy.
我们调查了晚期上皮性卵巢癌（EOC）患者在接受最大程度细胞减灭术后反应性血小板增多症的发生率及其对患者生存的影响。我们回顾性分析了2012年1月1日至2017年12月31日期间因晚期EOC接受初次细胞减灭术患者的电子病历。我们分析了手术前、围手术期以及辅助化疗每个周期后不同时间点的血清血小板计数。共有474例患者符合分析条件。其中，401例患者（84.6%）为国际妇产科联盟（FIGO）III期疾病状态。最常见的组织学类型是浆液性腺癌（405例患者，85.4%）。79例患者（22.6%）接受了脾切除术，326例患者（68.8%）实现了最佳细胞减灭。术后一周，整个队列中有165例患者（34.8%）出现血小板增多症。与未接受脾切除术的患者相比，接受脾切除术的患者血小板计数更高。特别是，在多因素分析中，辅助化疗第五周期的血小板增多症对总生存的影响最为显著。在逻辑回归模型中，脾切除术与化疗第五周期的血小板增多症显著相关。初次细胞减灭术后的反应性血小板增多症与晚期EOC患者的不良生存相关，尤其是在辅助化疗期间出现血小板增多症时。
