Aggressive ovarian cancer may be linked to the presence of thrombocytosis, report investigators from Cedars-Sinai Medical Center in Los Angeles. The findings, presented at the 2002 annual meeting of the Society of Gynecologic Oncologists, may lead to the development of more targeted therapies and help physicians to offer their patients more effective treatment options.
"Our findings show that thrombocytosis correlates with a more aggressive tumor biology in ovarian cancer and a poorer response to treatment," said Dr. Beth Karlan, medical director of the Women’s Cancer Research Institute at Cedars-Sinai Medical Center and senior author of the study. "Knowing which patients have this disorder in addition to their cancer will enable us to select patients who might benefit from experimental and other treatment approaches."
To determine whether thrombocytosis played a role in ovarian cancer tumor growth and metastasis, the investigators examined the records of 183 consecutive patients with and without thrombocytosis who had undergone surgery for advanced ovarian cancer. They found that 41 of the 183 patients demonstrated thrombocytosis prior to surgery and that those with the disorder had higher CA-125 levels, more advanced-stage disease, higher-grade tumors, and a greater tendency that their cancer had spread to the lymph nodes.
"These findings indicate that thrombocytosis is somehow linked to more aggressive ovarian cancer," said Dr. Karlan. "Our next step will be to figure out whether thrombocytosis is a reaction to more aggressive ovarian cancer or whether the disorder itself exacerbates the disease, leading to poorer treatment outcomes for patients. What we find may also point to novel prevention approaches for our patients."
Impact on Survival
Although surgery successfully removed most of the cancer in 87% of all patients with and without thrombocytosis, the investigators found that almost half of the patients with thrombocytosis prior to surgery demonstrated a greater degree of residual cancer after surgery. On the other hand, only 4 of the 142 patients without thrombocytosis were found to have residual disease greater than 1 cm after surgery. Moreover, patients with thrombocytosis remained disease-free for only about 38 months, while those without the disorder remained disease-free for approximately 49 months. Ultimately, the women with ovarian cancer who also had thrombocytosis lived 15 months less than those who did not have the disorder prior to surgery.