title: The prognostic significance of thrombocytosis in epithelial ovarian carcinoma.
abstract: OBJECTIVE
  The objective of this study was to determine the incidence of thrombocytosis in epithelial ovarian carcinoma and examine associations with clinico-pathologic features. Thrombocytosis (platelet counts >400 x 10(9)/l) has been identified as a poor prognostic factor in many cancers. Platelet-secreted factors may contribute to metastasis, invasion, and primary tumor growth.
  
  
  METHODS
  One hundred eighty-three patients with invasive epithelial ovarian or primary peritoneal carcinomas were identified between January 1996 and December 2000. Records were retrospectively reviewed and data analyzed using chi(2), Student's t test, and Cox proportional hazards model; survival was analyzed by the method of Kaplan and Meier.
  
  
  RESULTS
  Forty-one of 183 (22.4%) patients had thrombocytosis at primary diagnosis. Patients with preoperative thrombocytosis were found to have greater elevations of CA-125 (P = 0.026), more advanced stage disease (P = 0.016), higher grade tumors (P = 0.010), more frequent lymph node metastases (P = 0.018), and greater volume of ascites (P < 0.0001). One hundred sixty of 183 (87.4%) patients achieved optimal cytoreduction; patients with thrombocytosis demonstrated a greater likelihood of suboptimal resection (residual disease >1 cm; 19/41 vs. 4/142 in patients without thrombocytosis, P < 0.0001). Patients with thrombocytosis had a shorter disease-free interval (12 vs. 34 months, P < 0.0001) and overall survival (28 vs. 79 months, P < 0.0001). On multivariate analysis, thrombocytosis retained significance as a poor prognostic indicator in patients with stage III and IVA disease (P = 0.04).
  
  
  CONCLUSIONS
  Thrombocytosis is a frequent preoperative finding in ovarian and peritoneal carcinomas and may be a marker of aggressive tumor biology.
authors.affiliation: Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Geffen School of Medicine at UCLA, Los Angeles, CA 90048, USA. Andrew.Li@cshs.org
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Li
authors.forename: Alison C
authors.initials: AC
authors.lastname: Madden
authors.forename: Ilana
authors.initials: I
authors.lastname: Cass
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Leuchter
authors.forename: Leo D
authors.initials: LD
authors.lastname: Lagasse
authors.forename: Beth Y
authors.initials: BY
authors.lastname: Karlan
mesh_terms: D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000097:blood* / Q000150:complications / Q000473:pathology; D013922:Thrombocytosis / Q000150:complications*