Ovarian cancer recurrence

MIAMI BEACH - Thrombocytosis is associated with more aggressive tumor biology in patients with epithelial ovarian cancer, according to a recent retrospective study.

That finding has immediate implications for the management of ovarian cancer patients with thrombocytosis. Specifically, because cancers are more likely to recur in patients with thrombocytosis, it is appropriate to individualize treatment and consider using experimental therapies in an effort to improve long-term survival in these patients, Dr. Andrew J. Li said in a poster presentation at the annual meeting of the Society of Gynecologic Oncologists.

The results could also lead to development of more targeted therapies, said Dr. Li of Cedars-Sinai Medical Center, Los Angeles.

In the study, 183 consecutive patients with invasive epithelial ovarian carcinoma or primary peritoneal carcinoma underwent primary surgical cytoreduction. Of these patients, 41 had preoperative thrombocytosis and a disease-free interval of 37.9 months, compared with 48.9 months in those without thrombocytosis.

Overall survival also was shorter in women with thrombocytosis (48.6 months vs. 63.75 months), he said.

The mean level of CA 125 was 1,711 in the thrombocytosis patients, compared with 1,008 in those without thrombocytosis. Women with thrombocytosis were more likely to have stage III or IV disease and grade 3 tumors, while those without the blood disorder were more likely to have stage I or II disease and grade 1 or 2 tumors, he said at the meeting, also sponsored by the American College of Surgeons.

Furthermore, the volume of ascites was higher, the frequency of lymph node metastases was greater, and residual disease greater than 1 cm was more common in the thrombocytosis patients.