Secondary Thrombocytosis as a poor prognostic indicator in ovarian carcinoma
Keywords:
Secondary thrombocytosis, Surface epithelial ovarian tumors, Ovarian carcinoma, FIGO staging, Ascites, Poor prognosticator
Abstract
Introduction: Secondary thrombocytosis has been identified in many solid tumors including ovarian carcinoma and has a poor prognostic value in many cases. Platelets and Platelet-related factors may contribute to metastasis, invasion and primary tumor growth.
Objective: The objective of the present study is to determine the incidence of thrombocytosis in ovarian carcinoma and its importance as a poor prognosticator.
Materials and methods: One sixty cases of epithelial ovarian tumors were studied prospectively between the period of October 2010 to June 2012 in the Department of Pathology, Kasturba Medical College Mangalore. Other causes of secondary thrombocytosis were excluded from the study. All the data for all the cases were obtained and were statistically analysed by Chi-square test and Fisher’s exact test
.Results: One sixty cases were studied in the present study. Mean age in the present study was 43.64 years and the mean age of patients with malignancy was 53.18 years. Majority of the cases were benign (64.3%), followed by malignant (31.3%) and borderline tumors (4.4%). Mean platelet count in the study was 321x109 /L, and 80% of malignant cases had thrombocytosis as compared to 42.9% of borderline cases and 5.8% of benign cases, which is highly significant (p=0.0001).Predominant cases of ovarian carcinomas were in stage III (80%) followed by stage IV (17.5%) and stage II (2.5%).
Conclusion: Pre-operative secondary thrombocytosis is a frequent finding in ovarian carcinoma and is significantly associated withadvanced FIGO stage. The presence of thrombocytosis acts as a poor prognosticator in epithelial ovarian carcinoma.
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References
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34. van der Zee AGJ, de Cuyper EMJ, Limburg PC, de Bruijn HWA, Hollema H, Bijzet J, et al. Higher levels of interleukin-6 in cystic fluids from patients with malignant versus benign ovarian tumors correlate with decreased haemoglobin levels and increased platelet counts. Cancer 1995;75:1004-9.
35. Lane D, Matte I, Rancourt C, Piche A. Prognostic significance of IL-6 and IL-8 ascites levels in ovarian cancer patients. BMC Cancer 2011 May 30;11:210-15.[pubmed]
2. Griesshammer M, Bangerter M, Sauer T, Wennauer R, Bergmann L, Heimpel H. Aetiology and clinical significance of thrombocytosis: analysis of 732 patients with an elevated platelet count. J Intern Med 1999 Mar;245(3):295-300.[pubmed]
3. Santhosh-Kumar CR, Yohannan MD, Higgy KE, Al-Mashha-dani SA. Thrombocytosis in adults: analysis of 777 patients. J Intern Med 1991 June;229(6):493-5.[pubmed]
4. Levin J, Conley CL. Thrombocytosis associated with malignant disease. Arch Intern Med 1964 Oct;114(4):497-500.[pubmed]
5. Crasta JA, Premlatha TS, Krishnan SM, Vallikad E, Rameshkumar K. Significance of preoperative thrombocytosis in epithelial ovarian cancer. Indian J PatholMicrobiol 2010 Jan 19;53(1):54-6.[pubmed]
6. Gücer F, Tamussino K, Keil F, Balkanli-Kaplan P, Yüce MA. Thrombocytosis in gynecologic malignancies. Anticancer Res 2004;24:2053-60.[pubmed]
7. Li AJ, Madden AC, Cass I, Leuchter RS, Lagasse LD, Karlan BY. The prognostic significance of thrombocytosis in epithelial ovarian carcinoma. GynecolOncol 2004 Jan;92(1):211-4.[pubmed]
8. Tranum BL, Haut A. Thrombocytosis: platelet kinetics in neoplasis. J Lab Clin Med 1974 Nov;84(5):615-9.[pubmed]
9. Soonthornthum T, Suraseraneewong V, Kengsakol K, Wijaithum K, Kasemsan P, Prommatt S. Thrombocytosis in advanced epithelial ovarian cancer. J Med Assoc Thai 2007;90(8):1495-500.[pubmed]
10. Pedersen LM, Milman N. Diagnostic significance of platelet count and other blood analyses in patients with lung cancer. Oncol Rep 2003 Jan-Feb;10(1):213-6.[pubmed]
11. O’Keefe SC, Marshall FF, Issa MM, Harmon MP, Petros JA. Thrombocytosis is associated with a significant increase in the cancer specific death rate after radical nephrectomy. J Urol 2002 Oct;168(4 pt 1):1378-80.[pubmed]
12. Ikeda M, Furukawa H, Imamura H, Shimizu J, Ishida H, Masutani S, et al. Poor prognosis associated with thrombocytosis in patients with gastric cancer. Ann SurgOncol2002;9:287-91.[pubmed]
13. Benoy I, Salgado R, Colpaert C, Weytjens R, Vermeulen PB, Dirix LY. Serum interleukin 6, plasma VEGF, serum VEGF and VEGF platelet load in breast cancer patients. Clin Breast Cancer 2002 Jan;2(4):311-5.[pubmed]
14. Schwarz RE, Keny H. Preoperative platelet count predicts survival after resection of periampullary adenocarcinoma. Hepatogastroenterology 2001 Set-Oct;48(41):1493-8.[pubmed]
15. Costantini V, Zacharski LR, Moritz TE, Edwards RL. The platelet count in carcinoma of the lung and colon. ThrombHaemost1990;64:501-5.[pubmed]
16. Tamussino KF, Gucer F, Reich O, Moser F, Petru E, Scholz HS. Pretreatment haemoglobin, platelet count, and prognosis in endometrial carcinoma. Int J Gynecol Cancer 2001 Dec 20;11:236-40.
17. Scholz HS, Petru E, Gucer F, Haas J, Tamussino K, Winter R. Preoperative thrombocytosis is an independent prognostic factor in stage III and IV endometrial cancer. Anticancer Res 2000 Sep 1;20(5C):3983-5.[pubmed]
18. Gücer F, Moser F, Tamussino K, Reich O, Haas J, Arikan G, et al. Thrombocytosis as a prognostic factor in endometrial carcinoma. GynecolOncol1998;70:210-4.[pubmed]
19. Hefler L, Mayerhofer K, Leibman B, Obermair A, Reinthaller A, Kainz C, et al. Tumoranemia and thrombocytosis in patients with vulvar cancer. Tumour Biol2000;21:309-14.[pubmed]
20. Lavie O, Comerci G, Daras V, Bolger BS, Lopes A, Monaghan JM. Thrombocytosis in women with vulvar carcinoma. GynecolOncol 1999 Jan;72(1):82-6.[pubmed]
21. Zeimet AG, Marth C, Müller-Holzner E, Daxenbichler G, Dapunt O. Significance of thrombocytosis in patients with epithelial ovarian cancer. Am J ObstetGynecol 1994 Feb;170(2):549-54.[pubmed]
22. Menczer J, Schejter E, Geva D, Ginath S, Zakut H. Ovarian carcinoma associated thrombocytosis. Correlation with prognostic factors and with survival. Eur J GynaecolOncol 1998;19(1):82-4.[pubmed]
23. Chalas E, Welshinger M, Engellener W, Chumas J, Barbieri R, Mann WJ. The clinical significance of thrombocytosis in women presenting with a pelvic mass. Am J ObstetGynecol1992;166:974-7.[pubmed]
24. Kerpsack JT, Finan MA. Thrombocytosis as a predictor of malignancy in women with a pelvic mass. J Reprod Med 2000 Nov 1;45(11):929-32.[pubmed]
25.Gupta G P, Massagué J. Platelets and metastasis revisited: a novel fatty link. J Clin Invest 2004 Dec 15;114(12):1691-3.[pubmed]
26. Tavassoli FA, Devilee P. Pathology and genetics of tumors of the breast and female genital organs. Lyon: International Agency for Research on Cancer; 2008. P.114.
27. Bouanene H, Harrabi I, Ferchichi S, Limem HB, Miled A. Factors predictive of elevated serum CA125 levels in patients with epithelial ovarian cancer. Bull Cancer 2007;94:E18-22.
28. Obermair A, Handisurya A, Kaider A, Sevelda P, Kӧlbl H, Gitsch G. The relationship of pretreatment serum haemoglobin level to the survival of epithelial ovarian carcinoma patients. Cancer 1998 Aug 15;83:726-31.[pubmed]
29. Bozkurt N, Yuce K, Basaran M, Kose F, Ayhan A. Correlation of platelet count with second-look laparatomy results and disease progression in patients with advanced epithelial ovarian cancer. ObstetGynecol 2004 Jan;103(1):82-5.[pubmed]
30. Gastl G, Plante M, Finstad CL, Wong GY, Federici MG, Bander NH, et al. High IL-6 levels in ascitic fluid correlate with reactive thrombocytosis in patients with epithelial ovarian cancer. Br J Haematol 1993 Mar;83(3):433-41.[pubmed]
31. Lund B, Williamson P. Prognostic factors for outcome of and survival after second-look laparotomy in patients with advanced ovarian cancer. ObstetGynecol 1990 Oct 1;76(4):617-22.[pubmed]
32. Shen-Gunther J, Mannel RS: Ascites as a predictor of ovarian malignancy. GynecolOncol 2002 Oct;87(1):77-83.[pubmed]
33. Puiffe ML, Le Page C, Filali-Mouhim A, Zietarska M, Ouellet V, Tonin PN, et al. Characterization of ovarian cancer ascites on cell invasion, proliferation, spheroid formation, and gene expression in an in vitro model of epithelial ovarian cancer. Neoplasia 2007 Oct;9(10):820-9.[pubmed]
34. van der Zee AGJ, de Cuyper EMJ, Limburg PC, de Bruijn HWA, Hollema H, Bijzet J, et al. Higher levels of interleukin-6 in cystic fluids from patients with malignant versus benign ovarian tumors correlate with decreased haemoglobin levels and increased platelet counts. Cancer 1995;75:1004-9.
35. Lane D, Matte I, Rancourt C, Piche A. Prognostic significance of IL-6 and IL-8 ascites levels in ovarian cancer patients. BMC Cancer 2011 May 30;11:210-15.[pubmed]
CITATION
DOI: 10.17511/jopm.2018.i03.08
Published: 2018-07-31
How to Cite
Dr. Shwetha Ramu, Dr. SupriyaSandeepa, Dr. Ruchi Sinha, & Dr. Narayana Murthy. (2018). Secondary Thrombocytosis as a poor prognostic indicator in ovarian carcinoma. Tropical Journal of Pathology and Microbiology, 4(3), 281-287. https://doi.org/10.17511/jopm.2018.i03.08
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Original Article
OAI - Open Archives Initiative
