Aggressive Ovarian Cancer May Be Linked to Blood Disorder

Aggressive ovarian cancer may be linked to the presenceof thrombocytosis, report investigators from Cedars-Sinai Medical Center in LosAngeles. The findings, presented at the 2002 annual meeting of the Society ofGynecologic Oncologists, may lead to the development of more targeted therapiesand help physicians to offer their patients more effective treatment options.

"Our findings show that thrombocytosis correlates with a more aggressivetumor biology in ovarian cancer and a poorer response to treatment," saidDr. Beth Karlan, medical director of the Women’s Cancer Research Institute atCedars-Sinai Medical Center and senior author of the study. "Knowing whichpatients have this disorder in addition to their cancer will enable us to selectpatients who might benefit from experimental and other treatmentapproaches."

Study Results

To determine whether thrombocytosis played a role in ovarian cancer tumorgrowth and metastasis, the investigators examined the records of 183 consecutivepatients with and without thrombocytosis who had undergone surgery for advancedovarian cancer. They found that 41 of the 183 patients demonstratedthrombocytosis prior to surgery and that those with the disorder had higherCA-125 levels, more advanced-stage disease, higher-grade tumors, and a greatertendency that their cancer had spread to the lymph nodes.

"These findings indicate that thrombocytosis is somehow linked to moreaggressive ovarian cancer," said Dr. Karlan. "Our next step will be tofigure out whether thrombocytosis is a reaction to more aggressive ovariancancer or whether the disorder itself exacerbates the disease, leading to poorertreatment outcomes for patients. What we find may also point to novel preventionapproaches for our patients."

Impact on Survival

Although surgery successfully removed most of the cancer in 87% of allpatients with and without thrombocytosis, the investigators found that almosthalf of the patients with thrombocytosis prior to surgery demonstrated a greaterdegree of residual cancer after surgery. On the other hand, only 4 of the 142patients without thrombocytosis were found to have residual disease greater than1 cm after surgery. Moreover, patients with thrombocytosis remained disease-freefor only about 38 months, while those without the disorder remained disease-freefor approximately 49 months. Ultimately, the women with ovarian cancer who alsohad thrombocytosis lived 15 months less than those who did not have the disorderprior to surgery.

"Now that we know that surgery is less likely to remove all the visiblecancer in patients with thrombocytosis and that these patients’ cancers aremore likely to recur, we can individualize their treatments or use experimentaltherapies, which may improve their long-term survival," said Dr. Karlan.