Vascular endothelial growth factor staining and elevated INR in advanced epithelial ovarian carcinoma.
BACKGROUND
The purpose of this study was to determine whether vascular endothelial growth factor (VEGF) expression in tumors correlates with the incidence of an elevated prothrombin time (PT), specifically an international normalized ratio (INR) > or = 1.4, in patients undergoing primary surgical cytoreduction for ovarian cancer.


METHODS
INRs were obtained on all patients perioperatively. VEGF expression was determined by immunostaining of tumor specimens using published protocols.


RESULTS
One hundred patients underwent surgical cytoreduction. Sixty-seven percent of patients had postoperative INR of 1.4 or greater. INRs of greater than or equal to 1.8 were found in 5% of patients. INR elevation was independent of mean estimated blood loss (EBL) with the EBL in the patients with INRs > or = 1.4 not significantly different than the EBL in the patients with INRs < 1.4 (660 ml vs. 530 ml, P = 0.09). There was a significant correlation between elevated INR and tumor VEGF immunostaining (P < 0.005). All but one patient with an elevated INR had positive VEGF staining.


CONCLUSIONS
In conclusion, development of an elevated INR (INR > or = 1.4) is common in patients undergoing primary surgical cytoreduction. Positive tumor VEGF staining is very common in patients having a postoperative coagulopathy.
Geisler
John P
JP
Indiana Women's Oncology, Division of Gynecologic Oncology, St. Vincent Hospitals-Indianapolis, Indiana. USA. jgeisler@indianawomensoncology.com
Miller
Greg A
GA
Broshears
John R
JR
Manahan
Kelly J
KJ
D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019934:International Normalized Ratio; D010051:Ovarian Neoplasms / Q000378:metabolism / Q000601:surgery*; D019990:Perioperative Care; D011517:Prothrombin Time; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
D042461:Vascular Endothelial Growth Factor A