Evaluating the prognostic significance of preoperative thrombocytosis in epithelial ovarian cancer.
Evaluating the prognostic significance of preoperative thrombocytosis in epithelial ovarian cancer.
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DOI：
10.1016/j.ygyno.2013.05.038
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发表时间：
2013-09
影响因子：
4.7
通讯作者：
Bakkum-Gamez JN
中科院分区：
文献类型：
--
作者：
Allensworth SK;Langstraat CL;Martin JR;Lemens MA;McGree ME;Weaver AL;Dowdy SC;Podratz KC;Bakkum-Gamez JN
术前血小板增多已被认为是上皮性卵巢癌（EOC）的阴性预后标志。我们评估血小板增多是否是EOC复发和死亡的独立危险因素。从2003年1月2日至2008年12月29日期间接受EOC分期的587名女性中回顾性提取围手术期患者特征和护理过程变量（国家手术质量改进计划（NSQIP）定义）。血小板增多症定义为血小板计数>450 × 109/L。采用Kaplan-Meier方法确定无病生存期（DFS）和总生存期（OS）。用考克斯比例风险回归和风险比（HR）评估相关性。术前血小板增多的发生率为22.3%。1年和3年DFS分别为70.8%和36.0%。1年和3年OS分别为83.3%和54.3%。腹水、低血红蛋白、晚期疾病和接受围手术期浓缩红细胞输注与血小板增多独立相关。年龄较大和冠状动脉疾病的存在与血小板增多症的可能性较低有关。总的来说，血小板增多是复发风险增加的独立预测因子。在早期（I/II）病例中，死亡风险增加了5倍，疾病复发风险增加了近8倍，与血小板增多独立相关。术前血小板增多预示着EOC的DFS恶化。在疾病早期，血小板增多是DFS和OS恶化的有力预测因子，需要进一步评估循环血小板衍生因子对EOC生存的影响。血小板增多症还与广泛的初始疾病负担、可测量的残留疾病和术后后遗症相关。术前血小板水平可能对初次减血咨询有价值。
Preoperative thrombocytosis has been implicated as a negative prognostic marker for epithelial ovarian cancer (EOC). We assessed whether thrombocytosis is an independent risk factor for EOC recurrence and death. Perioperative patient characteristics and process-of-care variables (National Surgical Quality Improvement Program (NSQIP)-defined) were retrospectively abstracted from 587 women who underwent EOC staging between 1/2/03–12/29/08. Thrombocytosis was defined as platelet count >450 × 109/L. Disease-free survival (DFS) and overall survival (OS) were determined using Kaplan-Meier methods. Associations were evaluated with Cox proportional hazards regression and hazard ratios (HR). The incidence of preoperative thrombocytosis was 22.3%. DFS was 70.8% and 36.0% at 1 and 3 years. OS was 83.3% and 54.3% at 1 and 3 years. Ascites, lower hemoglobin, advanced disease, and receipt of perioperative packed red blood cell transfusion were independently associated with thrombocytosis. Older age and the presence of coronary artery disease were associated with lower likelihood of thrombocytosis. Overall, thrombocytosis was an independent predictor of increased risk of recurrence. Among early stage (I/II) cases, there was a 5-fold increase in the risk of death and nearly 8-fold risk of disease recurrence independently associated with thrombocytosis. Preoperative thrombocytosis portends worse DFS in EOC. In early stage disease, thrombocytosis is a potent predictor of worse DFS and OS and further assessment of the impact of circulating platelet-derived factors on EOC survival is warranted. Thrombocytosis is also associated with extensive initial disease burden, measurable residual disease, and postoperative sequelae. Preoperative platelet levels may have value in primary cytoreduction counseling.
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影响因子：
8.4
作者：
Manenti, L;Paganoni, P;Giavazzi, R
通讯作者：
Giavazzi, R
影响因子：
9.8
作者：
Aletti, Giovanni D.;Dowdy, Sean C.;Cliby, William A.
通讯作者：
Cliby, William A.
影响因子：
4.7
作者：
Li, AJ;Madden, AC;Karlan, BY
通讯作者：
Karlan, BY
DOI：
10.4103/1319-3767.77245
发表时间：
2011-03
期刊：
Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association
影响因子：
--
作者：
Aminian A;Karimian F;Mirsharifi R;Alibakhshi A;Dashti H;Jahangiri Y;Safari S;Ghaderi H;Noaparast M;Hasani SM;Mirsharifi A
通讯作者：
Mirsharifi A
影响因子：
2.6
作者：
Gungor, Tayfun;Kanat-Pektas, Mine;Mollamahmutoglu, Leyla
通讯作者：
Mollamahmutoglu, Leyla