Abstract
ObjectivesWe sought to determine the impact of pretreatment plasma platelet levels, dimerized plasmin fragment (D-dimer) and fibrinogen in recurrent epithelial ovarian cancer (EOC) and the impact of platelet levels on SKOV3 cell lines growth and responsiveness to chemotherapy.MethodsUnder approval of ethical committee, we identified 104 women with recurrent EOC who underwent treatment between January 2010 and February 2015. Reviewing clinical, laboratory, and pathologic records from this retrospective cohort, we analyzed the correlation between pretreatment plasma D-dimer, fibrinogen, platelet levels and clinicopathological parameters, progression free survival (PFS) and overall survival (OS). Inco-culture experiments human ovarian cancer SKOV3 cell lines were used to test the effect of platelet levels on tumor growth and responsiveness to docetaxel.ResultsOf the 104 recurrent EOC, thrombocytosis at diagnosis and the decrease of platelet count by less than 25% after primary therapy were associated with worse median progression free survival (P = 0.003;P = 0.021) and median overall survival (P = 0.009;P = 0.009). Mean platelet levels declined at the end of primary therapy(P < 0.001) and rose at recurrence(P = 0.007). In multivariate analysis, elevated platelet levels at primary therapy and the decrease of platelet count less than 25% after primary therapy were unfavorable prognostic factor for PFS(P = 0.022; P = 0.015) and OS(P = 0.013;P = 0.007) in recurrent EOC, but elevated plasma D-dimer and fibrinogen were not. In SKOV-3 ovarian cancer cell lines, suitable concentration platelet co-culture protected against apoptosis (P < 0.05).ConclusionsPlatelet count during treatment could be used as a biomarker used for monitoring the disease recurrence and predicting treatment response. And platelet with suitable concentration co-culture protected against apoptosis in SKOV3 cell line, which may explain clinical observations.
Highlights
Malignant tumors are frequently accompanied by increased risk of hematological abnormalities
We considered whether plasma D-dimer, fibrinogen, and platelet levels could serve as biomarkers, like Cancer antigen 125 (CA125), to monitor treatment response and to follow up during the surveillance for recurrence of the epithelial ovarian cancer (EOC)
We evaluate the association between pretreatment plasma D-dimer, fibrinogen, platelet levels, survival, and other clinic-pathologic factors in women with recurrent EOC and the impact of platelet levels on SKOV3 cell lines growth and responsiveness to chemotherapy
Summary
Malignant tumors are frequently accompanied by increased risk of hematological abnormalities. Elevated plasma D-dimer, fibrinogen, and platelet levels have been found in various malignancies [1] and are correlated with poor clinical outcome [2, 3], while some do not find any correlation [4, 5]. Thrombocytosis, accompanied by increasing of platelet aggregation rates, is associated with more aggressive tumor biology in EOC [8]. Despite the available literature regarding elevated plasma D-dimer, fibrinogen, and platelet levels at the time of primary treatment, it is unclear if this three at the time of recurrence have clinical significance. We evaluate the association between pretreatment plasma D-dimer, fibrinogen, platelet levels, survival, and other clinic-pathologic factors in women with recurrent EOC and the impact of platelet levels on SKOV3 cell lines growth and responsiveness to chemotherapy
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