title: Clinical and prognostic significance of coagulation assays in advanced epithelial ovarian cancer.
abstract: OBJECTIVE
  Epithelial ovarian cancer (EOC) is the leading cause of death among gynecological tumors and usually diagnosed at advanced stage. We aimed to identify the clinical and prognostic relevance of coagulation tests and their correlation with serum CA-125 levels in advanced EOC.
  
  
  METHODS
  A total of 33 advanced-stage (stages III and IV) EOC patients were enrolled in the study. Of these patients, 17 had received neoadjuvant chemotherapy and 16 patients received chemotherapy after optimal debulking surgery. Several clinicopathologic factors, coagulation assays, routine biochemistry tests, and serum CA-125 levels were evaluated before treatment and compared with healthy subjects.
  
  
  RESULTS
  All coagulation tests including prothrombin time (PT), activated partial thromboplastin time, international normalized ratio, fibrinogen, D-dimer, and platelet revealed statistically significant difference between patients and control subjects (P ≤ 0.001). Elevated CA-125 levels were correlated with higher D-dimer values (P = 0.03). Prolonged PT was associated with poorer both overall (P = 0.03) and progression-free survival rates (P = 0.04).
  
  
  CONCLUSIONS
  Correlation of CA-125 with D-dimer is supposed to reflect hyperactivation of fibrinolytic pathway in the presence of a higher tumor load. Alterations in coagulation pathway reflected by prolonged PT support prognostic effects on survival of advanced-stage EOC patients.
authors.affiliation: Institute of Oncology, University of Istanbul, Istanbul, Turkey. faruktas2002@yahoo.com
authors.forename: Faruk
authors.initials: F
authors.lastname: Tas
authors.forename: Leyla
authors.initials: L
authors.lastname: Kilic
authors.forename: Elif
authors.initials: E
authors.lastname: Bilgin
authors.forename: Serkan
authors.initials: S
authors.lastname: Keskin
authors.forename: Fatma
authors.initials: F
authors.lastname: Sen
authors.forename: Rumeysa
authors.initials: R
authors.lastname: Ciftci
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yildiz
authors.forename: Vildan
authors.initials: V
authors.lastname: Yasasever
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D001780:Blood Coagulation Tests; D000077216:Carcinoma, Ovarian Epithelial; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D010051:Ovarian Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor