Evaluating the prognostic significance of preoperative thrombocytosis in epithelial ovarian cancer

S. K. Allensworth, C. L. Langstraat, J. R. Martin, M. A. Lemens, M. E. McGree, A. L. Weaver, Sean Christopher Dowdy, K. C. Podratz, Jamie N Bakkum-Gamez

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Abstract

Objective Preoperative thrombocytosis has been implicated as a negative prognostic marker for epithelial ovarian cancer (EOC). We assessed whether thrombocytosis is an independent risk factor for EOC recurrence and death. Methods Perioperative patient characteristics and process-of-care variables (National Surgical Quality Improvement Program (NSQIP)-defined) were retrospectively abstracted from 587 women who underwent EOC staging between 1/2/03-12/29/08. Thrombocytosis was defined as platelet count > 450 × 109/L. Disease-free survival (DFS) and overall survival (OS) were determined using Kaplan-Meier methods. Associations were evaluated with Cox proportional hazards regression and hazard ratios (HR). Results The incidence of preoperative thrombocytosis was 22.3%. DFS was 70.8% and 36.0% at 1 and 3 years. OS was 83.3% and 54.3% at 1 and 3 years. Ascites, lower hemoglobin, advanced disease, and receipt of perioperative packed red blood cell transfusion were independently associated with thrombocytosis. Older age and the presence of coronary artery disease were associated with lower likelihood of thrombocytosis. Overall, thrombocytosis was an independent predictor of increased risk of recurrence. Among early stage (I/II) cases, there was a 5-fold increase in the risk of death and nearly 8-fold risk of disease recurrence independently associated with thrombocytosis. Conclusion Preoperative thrombocytosis portends worse DFS in EOC. In early stage disease, thrombocytosis is a potent predictor of worse DFS and OS and further assessment of the impact of circulating platelet-derived factors on EOC survival is warranted. Thrombocytosis is also associated with extensive initial disease burden, measurable residual disease, and postoperative sequelae. Preoperative platelet levels may have value in primary cytoreduction counseling.

Original languageEnglish (US)
Pages (from-to)499-504
Number of pages6
JournalGynecologic Oncology
Volume130
Issue number3
DOIs
StatePublished - Sep 2013

Fingerprint

Thrombocytosis
Disease-Free Survival
Survival
Recurrence
Ovarian epithelial cancer
Blood Platelets
Erythrocyte Transfusion
Neoplasm Staging
Quality Improvement
Platelet Count
Ascites
Counseling
Coronary Artery Disease
Hemoglobins

Keywords

  • Epithelial ovarian cancer
  • Paraneoplastic thrombocytosis

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Allensworth, S. K., Langstraat, C. L., Martin, J. R., Lemens, M. A., McGree, M. E., Weaver, A. L., ... Bakkum-Gamez, J. N. (2013). Evaluating the prognostic significance of preoperative thrombocytosis in epithelial ovarian cancer. Gynecologic Oncology, 130(3), 499-504. https://doi.org/10.1016/j.ygyno.2013.05.038

Evaluating the prognostic significance of preoperative thrombocytosis in epithelial ovarian cancer. / Allensworth, S. K.; Langstraat, C. L.; Martin, J. R.; Lemens, M. A.; McGree, M. E.; Weaver, A. L.; Dowdy, Sean Christopher; Podratz, K. C.; Bakkum-Gamez, Jamie N.

In: Gynecologic Oncology, Vol. 130, No. 3, 09.2013, p. 499-504.

Research output: Contribution to journalArticle

Allensworth, SK, Langstraat, CL, Martin, JR, Lemens, MA, McGree, ME, Weaver, AL, Dowdy, SC, Podratz, KC & Bakkum-Gamez, JN 2013, 'Evaluating the prognostic significance of preoperative thrombocytosis in epithelial ovarian cancer', Gynecologic Oncology, vol. 130, no. 3, pp. 499-504. https://doi.org/10.1016/j.ygyno.2013.05.038
Allensworth SK, Langstraat CL, Martin JR, Lemens MA, McGree ME, Weaver AL et al. Evaluating the prognostic significance of preoperative thrombocytosis in epithelial ovarian cancer. Gynecologic Oncology. 2013 Sep;130(3):499-504. https://doi.org/10.1016/j.ygyno.2013.05.038
Allensworth, S. K. ; Langstraat, C. L. ; Martin, J. R. ; Lemens, M. A. ; McGree, M. E. ; Weaver, A. L. ; Dowdy, Sean Christopher ; Podratz, K. C. ; Bakkum-Gamez, Jamie N. / Evaluating the prognostic significance of preoperative thrombocytosis in epithelial ovarian cancer. In: Gynecologic Oncology. 2013 ; Vol. 130, No. 3. pp. 499-504.
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abstract = "Objective Preoperative thrombocytosis has been implicated as a negative prognostic marker for epithelial ovarian cancer (EOC). We assessed whether thrombocytosis is an independent risk factor for EOC recurrence and death. Methods Perioperative patient characteristics and process-of-care variables (National Surgical Quality Improvement Program (NSQIP)-defined) were retrospectively abstracted from 587 women who underwent EOC staging between 1/2/03-12/29/08. Thrombocytosis was defined as platelet count > 450 × 109/L. Disease-free survival (DFS) and overall survival (OS) were determined using Kaplan-Meier methods. Associations were evaluated with Cox proportional hazards regression and hazard ratios (HR). Results The incidence of preoperative thrombocytosis was 22.3{\%}. DFS was 70.8{\%} and 36.0{\%} at 1 and 3 years. OS was 83.3{\%} and 54.3{\%} at 1 and 3 years. Ascites, lower hemoglobin, advanced disease, and receipt of perioperative packed red blood cell transfusion were independently associated with thrombocytosis. Older age and the presence of coronary artery disease were associated with lower likelihood of thrombocytosis. Overall, thrombocytosis was an independent predictor of increased risk of recurrence. Among early stage (I/II) cases, there was a 5-fold increase in the risk of death and nearly 8-fold risk of disease recurrence independently associated with thrombocytosis. Conclusion Preoperative thrombocytosis portends worse DFS in EOC. In early stage disease, thrombocytosis is a potent predictor of worse DFS and OS and further assessment of the impact of circulating platelet-derived factors on EOC survival is warranted. Thrombocytosis is also associated with extensive initial disease burden, measurable residual disease, and postoperative sequelae. Preoperative platelet levels may have value in primary cytoreduction counseling.",
keywords = "Epithelial ovarian cancer, Paraneoplastic thrombocytosis",
author = "Allensworth, {S. K.} and Langstraat, {C. L.} and Martin, {J. R.} and Lemens, {M. A.} and McGree, {M. E.} and Weaver, {A. L.} and Dowdy, {Sean Christopher} and Podratz, {K. C.} and Bakkum-Gamez, {Jamie N}",
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T1 - Evaluating the prognostic significance of preoperative thrombocytosis in epithelial ovarian cancer

AU - Allensworth, S. K.

AU - Langstraat, C. L.

AU - Martin, J. R.

AU - Lemens, M. A.

AU - McGree, M. E.

AU - Weaver, A. L.

AU - Dowdy, Sean Christopher

AU - Podratz, K. C.

AU - Bakkum-Gamez, Jamie N

PY - 2013/9

Y1 - 2013/9

N2 - Objective Preoperative thrombocytosis has been implicated as a negative prognostic marker for epithelial ovarian cancer (EOC). We assessed whether thrombocytosis is an independent risk factor for EOC recurrence and death. Methods Perioperative patient characteristics and process-of-care variables (National Surgical Quality Improvement Program (NSQIP)-defined) were retrospectively abstracted from 587 women who underwent EOC staging between 1/2/03-12/29/08. Thrombocytosis was defined as platelet count > 450 × 109/L. Disease-free survival (DFS) and overall survival (OS) were determined using Kaplan-Meier methods. Associations were evaluated with Cox proportional hazards regression and hazard ratios (HR). Results The incidence of preoperative thrombocytosis was 22.3%. DFS was 70.8% and 36.0% at 1 and 3 years. OS was 83.3% and 54.3% at 1 and 3 years. Ascites, lower hemoglobin, advanced disease, and receipt of perioperative packed red blood cell transfusion were independently associated with thrombocytosis. Older age and the presence of coronary artery disease were associated with lower likelihood of thrombocytosis. Overall, thrombocytosis was an independent predictor of increased risk of recurrence. Among early stage (I/II) cases, there was a 5-fold increase in the risk of death and nearly 8-fold risk of disease recurrence independently associated with thrombocytosis. Conclusion Preoperative thrombocytosis portends worse DFS in EOC. In early stage disease, thrombocytosis is a potent predictor of worse DFS and OS and further assessment of the impact of circulating platelet-derived factors on EOC survival is warranted. Thrombocytosis is also associated with extensive initial disease burden, measurable residual disease, and postoperative sequelae. Preoperative platelet levels may have value in primary cytoreduction counseling.

AB - Objective Preoperative thrombocytosis has been implicated as a negative prognostic marker for epithelial ovarian cancer (EOC). We assessed whether thrombocytosis is an independent risk factor for EOC recurrence and death. Methods Perioperative patient characteristics and process-of-care variables (National Surgical Quality Improvement Program (NSQIP)-defined) were retrospectively abstracted from 587 women who underwent EOC staging between 1/2/03-12/29/08. Thrombocytosis was defined as platelet count > 450 × 109/L. Disease-free survival (DFS) and overall survival (OS) were determined using Kaplan-Meier methods. Associations were evaluated with Cox proportional hazards regression and hazard ratios (HR). Results The incidence of preoperative thrombocytosis was 22.3%. DFS was 70.8% and 36.0% at 1 and 3 years. OS was 83.3% and 54.3% at 1 and 3 years. Ascites, lower hemoglobin, advanced disease, and receipt of perioperative packed red blood cell transfusion were independently associated with thrombocytosis. Older age and the presence of coronary artery disease were associated with lower likelihood of thrombocytosis. Overall, thrombocytosis was an independent predictor of increased risk of recurrence. Among early stage (I/II) cases, there was a 5-fold increase in the risk of death and nearly 8-fold risk of disease recurrence independently associated with thrombocytosis. Conclusion Preoperative thrombocytosis portends worse DFS in EOC. In early stage disease, thrombocytosis is a potent predictor of worse DFS and OS and further assessment of the impact of circulating platelet-derived factors on EOC survival is warranted. Thrombocytosis is also associated with extensive initial disease burden, measurable residual disease, and postoperative sequelae. Preoperative platelet levels may have value in primary cytoreduction counseling.

KW - Epithelial ovarian cancer

KW - Paraneoplastic thrombocytosis

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