Thrombocytosis at secondary cytoreduction for recurrent ovarian cancer predicts suboptimal resection and poor survival

Cohen, Joshua G.; Tran, Arthur Quan; Rimel, B.J.; Cass, Ilana; Walsh, Christine; Karlan, Beth Y.; Li, Andrew J.

doi:10.1016/j.ygyno.2014.01.003

Cited by 24 publications

(16 citation statements)

References 21 publications

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“…This study and a smaller investigation by Menczer and colleagues also demonstrated that thrombocytosis may signify an increased risk of suboptimal surgical cytoreduction and is an independent poor prognostic factor [15]. A retrospective analysis of 107 women with recurrent ovarian cancer showed that thrombocytosis at the time of secondary cytoreductive surgery is associated with suboptimal resection and shortened overall survival [16]. …”

Section: Clinical Significance Of Paraneoplastic Thrombocytosis In Ovmentioning

confidence: 81%

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Platelet Effects on Ovarian Cancer

Davis

Afshar-Kharghan

Sood

2014

Seminars in Oncology

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Growing understanding of the role of thrombocytosis, high platelet turnover, and the presence of activated platelets in the circulation in cancer progression and metastasis has brought megakaryocytes into focus. Platelet biology is essential to hemostasis, vascular integrity, angiogenesis, inflammation, innate immunity, wound healing, and cancer biology. However, before megakaryocyte/platelet-directed therapies can be considered for clinical use, understanding of the mechanism and biology of paraneoplastic thrombocytosis in malignancy is required. Here, we provide an overview of the clinical implications, biological significance, and mechanisms of paraneoplastic thrombocytosis in the context of ovarian cancer.

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Section: Clinical Significance Of Paraneoplastic Thrombocytosis In Ovmentioning

confidence: 81%

“…Ovarian cancer cells adhere to and activate platelets to increase proliferation that can occur even without direct contact [16]. Both activated platelets and platelet releasate increases cancer cell invasion [28].…”

Section: Biological Significance Of Paraneoplastic Thrombocytosis In mentioning

confidence: 99%

Platelet Effects on Ovarian Cancer

Davis

Afshar-Kharghan

Sood

2014

Seminars in Oncology

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“…(2) Recent clinical work supports the relationship between thrombocytosis and poor prognosis in ovarian cancer. (4, 5)…”

Section: Introductionmentioning

confidence: 99%

Differential Platelet Levels Affect Response to Taxane-Based Therapy in Ovarian Cancer

Bottsford-Miller

Choi

Dalton

et al. 2015

Clinical Cancer Research

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Purpose We hypothesized that platelet levels during therapy could serve as a biomarker for response to therapy and that manipulation of platelet levels could impact responsiveness to chemotherapy. Experimental Design The medical records of patients with recurrent or progressive ovarian cancer were retrospectively queried for changes in platelet and CA-125 levels during primary therapy. In vitro co-culture experiments and in vivo orthotopic models of human ovarian cancer in mice were used to test the effect of modulating platelet levels on tumor growth and responsiveness to docetaxel. Results Thrombocytosis at the diagnosis of ovarian cancer correlated with decreased interval to progression (p = 0.05) and median overall survival (p = 0.007). Mean platelet levels corrected during primary therapy and rose at recurrence. Contrary to treatment-responsive patients, in a cohort of patients refractory to primary therapy, platelet levels did not normalize during therapy. In A2780, HeyA8, and SKOV3-ip1 ovarian cancer cell lines, platelet co-culture protected against apoptosis (p < 0.05). In orthotopic models of human ovarian cancer, platelet depletion resulted in 70% reduced mean tumor weight (p < 0.05). Compared to mice treated with docetaxel, mice treated with both docetaxel and platelet-depleting antibody had a 62% decrease in mean tumor weight (p = 0.04). Platelet transfusion increased mean aggregate tumor weight 2.4-fold (p < 0.05), blocked the effect of docetaxel on tumor growth (p = 0.55) and decreased tumor cell apoptosis. Pre-transfusion aspirinization of the platelets blocked the growth-promoting effects of transfusion. Conclusions Platelet-driven effects of chemotherapy response may explain clinical observations.

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“…Circulating cytokines and small inflammatory proteins, such as chemokines and matrix-degrading proteins, have been shown to aid tumor metastasis [5,8,21,22]. It has been suggested that preoperative indices of systemic inflammation such as the PLR, NLR and thrombocytosis may be valuable in predicting OS in many solid tumors including colorectal and ovarian cancers [1,4,10-13,20,22-25]. We did not find evidence of an association between the aforementioned markers of inflammation at the time of diagnosis and OS in patients with appendiceal carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…Absolute lymphocyte count (ALC) is considered a surrogate marker for the level of immunosuppression and nutritional status of patients and a prognostic factor for survival and recurrence in several cancers. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been used as indices of inflammation, and numerous studies have identified elevated NLR or PLR as adverse prognostic factors in cancers [11-13]. The aim of this study was to determine prognostic factors, including markers of systemic inflammation, for survival in a cohort of patients with stage III and IV appendiceal adenocarcinomas who were referred to a tertiary care center for HIPEC.…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors for survival in advanced appendiceal cancers

Khan

Diep

Tuttle

et al. 2017

CBM

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BACKGROUND Appendiceal cancer is a rare malignancy. The optimal pathologic classification and prognostic factors for survival and treatment strategies remain poorly understood. OBJECTIVE The aim of this retrospective cohort study was to determine prognostic factors, including markers of systemic inflammation, for survival in a cohort of patients with advanced appendiceal adenocarcinomas. METHODS The study included patients with advanced appendiceal carcinoma that were treated between January 2006 and June 2012. The associations between age, gender, histopathologic subtype of appendiceal malignancy and treatment with heated intraperitoneal chemotherapy (HIPEC) and overall survival (OS) were assessed. The relationship between various markers of inflammation (platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio) and OS was also evaluated. RESULTS A total of 49 patients met eligibility criteria. Female gender and low-grade adenocarcinoma were associated with increased OS. These data suggest that the use of HIPEC treatment may also be associated with improved OS, but the difference was not statistically significant (HR = 0.37 [0.12–1.18], p = 0.09). We found no evidence of an association between markers of inflammation at diagnosis and OS. CONCLUSIONS Histopathologic subtype and gender are associated with OS in patients with advanced appendiceal carcinoma. Baseline platelet levels, NLR, and PLR do not appear to be predictive of OS in this setting.

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Thrombocytosis at secondary cytoreduction for recurrent ovarian cancer predicts suboptimal resection and poor survival

Cited by 24 publications

References 21 publications

Platelet Effects on Ovarian Cancer

Platelet Effects on Ovarian Cancer

Differential Platelet Levels Affect Response to Taxane-Based Therapy in Ovarian Cancer

Prognostic factors for survival in advanced appendiceal cancers

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