Pergialiotis Vasilios, Vogiatzi Vokotopoulou Lito, Vlachos Dimitrios-Efthymios, Liontos Michalis, Kontomanolis Emmanuel, Thomakos Nikolaos
First Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, 'Alexandra' General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Eur J Obstet Gynecol Reprod Biol X. 2024 May 4;22:100312. doi: 10.1016/j.eurox.2024.100312. eCollection 2024 Jun.
An association between thrombocytosis and cancer progression and decreased survival has been observed for various forms of cancer. The aim of this study was to evaluate the impact of pre-treatment thrombocytosis on ovarian cancer survival. Medline, Scopus, Clinicaltrials.gov, Cochrane Central Register of Controlled Trials CENTRAL and Google Scholar were searched systematically for studies that compared survival outcomes of patients with ovarian cancer who had pre-treatment thrombocytosis with survival outcomes of patients with normal platelet counts. Fourteen articles were retrieved, with a total of 5414 patients with ovarian cancer. The methodological quality of included studies ranged between moderate and high. Patients with advanced stage disease were more likely to have pre-treatment thrombocytosis, and this was associated with lower rates of optimal debulking. Thrombocytosis was also associated with increased likelihood of recurrence of ovarian cancer [hazard ratio (HR) 2.01, 95 % confidence interval (CI) 1.34-3.01] and increased risk of death from ovarian cancer (HR 2.29, 95 % CI 1.35-3.90). The incidence of deep vein thrombosis was comparable in both groups (odds ratio 1.62, 95 % CI 0.48-5.46). Considering these findings, it is evident that pre-treatment thrombocytosis in patients with ovarian cancer is associated with increased risk of recurrence and death. Pre-treatment thrombocytosis is a potential sign of advanced stage disease, and may be predictive of suboptimal tumour debulking during surgery. Its association with other factors that affect survival, including platinum resistance and response to targeted therapy, remains poorly explored, although preliminary data suggest a potential correlation.
在多种癌症中均观察到血小板增多症与癌症进展及生存率降低之间存在关联。本研究的目的是评估治疗前血小板增多症对卵巢癌生存率的影响。我们系统检索了医学文献数据库（Medline）、Scopus数据库、美国国立医学图书馆临床试验注册库（Clinicaltrials.gov）、考克兰系统评价数据库（Cochrane Central Register of Controlled Trials CENTRAL）以及谷歌学术，以查找比较治疗前血小板增多的卵巢癌患者与血小板计数正常的患者生存结局的研究。共检索到14篇文章，涉及总共5414例卵巢癌患者。纳入研究的方法学质量从中等到高等不等。晚期疾病患者更有可能出现治疗前血小板增多症，且这与最佳肿瘤细胞减灭术的低发生率相关。血小板增多症还与卵巢癌复发可能性增加[风险比（HR）2.01，95%置信区间（CI）1.34 - 3.01]以及卵巢癌死亡风险增加（HR 2.29，95% CI 1.35 - 3.90）相关。两组深静脉血栓形成的发生率相当（优势比1.62，95% CI 0.48 - 5.46）。考虑到这些发现，显然卵巢癌患者治疗前血小板增多症与复发和死亡风险增加相关。治疗前血小板增多症是晚期疾病的一个潜在标志，可能预示手术期间肿瘤细胞减灭不充分。尽管初步数据表明存在潜在相关性，但其与其他影响生存的因素（包括铂耐药性和对靶向治疗的反应）之间的关联仍未得到充分探索。
