Prognostic impact of pretreatment thrombocytosis in epithelial ovarian cancer

Abstract

Aims: This study was aimed at investigating the prognostic impact of pretreatment thrombocytosis in epithelial ovarian cancer (EOC) patients in Lagos, Nigeria. Methods: This was a retrospective cohort study involving the review of the clinical record of 72 patients with histologically confirmed EOC who were managed at the Lagos University Teaching Hospital, Lagos, Nigeria over a 7-year period from January 2010 to December 2016. Information on the sociodemographic data and platelet counts at diagnosis of EOC were retrieved from the patients’ medical records. Descriptive statistics were then computed for all baseline patients’ characteristics. Survival analyses were carried out using the Kaplan-Meier estimates. Multivariate analysis of these data was performed with the Cox proportional hazards model. Results: This study revealed that the prevalence of pretreatment thrombocytosis was 41.7% among the women with EOC. Fifty-three (73.6%) of the women had the advanced-stage disease (FIGO stage III-IV) while 52 (72.2%) had high-grade disease (II-III). The majority (66.7%) of the women had a serous histological type of EOC while 76.4% had documented recurrence. Pretreatment thrombocytosis was significantly associated with the women’s parity ( P = 0.009), serum carbohydrate antigen 125 levels ( P = 0.018), median progression-free survival (PFS) ( P < 0.001), 3-year median overall survival (OS) ( P < 0.001), type of primary treatment ( P = 0.002), extent of cytoreduction ( P < 0.001), presence of ascites ( P = 0.002), International Federation of Gynecology and Obstetrics (FIGO) stage ( P = 0.008), and histological type ( P = 0.011). Pretreatment thrombocytosis was negatively associated with PFS (hazard ratio [HR] = 0.25; 95% CI 0.83, 0.75; P = 0.014) and 3-year OS (HR = 0.03; 95% CI 0.03, 0.27; P = 0.002). Conclusions: The study suggests that pretreatment thrombocytosis may be a useful predictor of survivals in EOC patients.

Predictors of early mortality risk in patients with epithelial ovarian cancer

“…Many recent studies have also shown that certain hematologic markers, can be used to identify individuals with a high risk of death from some tumors 27 , 28 , 29 including EOC. 11 , 30 The measurement of preoperative hematological markers is cheap, noninvasive, and relatively easy compared to using genetic molecular biomarkers. 30 Mortality was found to be associated with pretreatment platelet, hemoglobin, and white blood cell levels in our univariate analyses.…”

“…However, following adjustments in the final multivariate analyses, none of these hematological markers could independently predict early mortality risk in EOC patients and these findings confirmed that these markers could be surrogates for other prognostic indicators, such as advanced‑stage disease, suboptimal cytoreduction, or even medical comorbidity. 11 …”

“…However, the current study failed to demonstrate the role of parity as an independent risk predictor of mortality in patients with EOC. Many recent studies have also shown that certain hematologic markers, can be used to identify individuals with a high risk of death from some tumors 27–29 including EOC 11,30 . The measurement of preoperative hematological markers is cheap, noninvasive, and relatively easy compared to using genetic molecular biomarkers 30 .…”

“…This is even more important in resource‐limited settings with a much higher early mortality rate in ovarian cancer patients as they advance through the survival trajectory. 11 This current study, therefore, focused on identifying these important risk predictors of early mortality in EOC patients managed and followed up over 10 years period at the women's cancer unit of a university teaching hospital in Southwest Nigeria.…”

“…A risk‐stratification strategy using some of these patient and tumor characteristics is now being used to predict mortality risk and to identify EOC patients that require more intensive and individualized follow‐up surveillance plans. This is even more important in resource‐limited settings with a much higher early mortality rate in ovarian cancer patients as they advance through the survival trajectory 11 . This current study, therefore, focused on identifying these important risk predictors of early mortality in EOC patients managed and followed up over 10 years period at the women's cancer unit of a university teaching hospital in Southwest Nigeria.…”