Los Angeles (Embargoed until March 17, 2002, 1pm, EST) Aggressive ovarian cancer may be linked to the presence of thrombocytosis, a blood disorder characterized by high platelet cell counts, report investigators at Cedars-Sinai Medical Center. The findings, presented at the annual meeting of the Society of Gynecologic Oncologists, may lead to the development of more targeted therapies and help physicians to offer their patients more effective treatment options.
“Our findings show that thrombocytosis correlates with a more aggressive tumor biology in ovarian cancer and a poorer response to treatment,” said Dr. Beth Karlan, Medical Director of the Women’s Cancer Research Institute at Cedars-Sinai Medical Center and senior author of the study. “Knowing which patients have this disorder in addition to their cancer, will enable us to select patients who might benefit from experimental and other treatment approaches.”
Platelets, the smallest of the blood cells, are involved in clotting and enable the body to control bleeding. In normal conditions, platelet levels are regulated by factors in the bone marrow, but cancer cells may secrete substances that induce the marrow to produce platelets in excessively large quantities. In turn, platelets may then produce factors that cause cancer cells to grow or spread.
To determine whether thrombocytosis played a role in ovarian cancer tumor growth and metastasis, the investigators examined the records of 183 consecutive patients with and without thrombocytosis who had undergone surgery for advanced ovarian cancer. They found that 41 of the 183 patients demonstrated thrombocytosis prior to surgery and that those with the disorder had higher CA-125 levels, (a marker for ovarian cancer), more advanced stage disease, higher grade tumors, and a greater tendency of cancer that had spread to the lymph nodes.
“These findings indicate that thrombocytosis is somehow linked to more aggressive ovarian cancer,” said Dr. Karlan. “Our next step will be to figure out whether thrombocytosis is a reaction to more aggressive ovarian cancer or whether the disorder itself exacerbates the disease, leading to poorer treatment outcomes for patients. What we find may also point to novel prevention approaches for our patients.“
Although surgery successfully removed most of the cancer in 87 percent of all patients with and without thrombocytosis, the investigators found that almost half the patients with thrombocytosis prior to surgery demonstrated a greater degree of residual cancer after the operation. On the other hand, they found that only four of the 142 patients without thrombocytosis had residual disease greater than 1 cm after surgery. Further, the patients with thrombocytosis remained disease-free for only about 38 months, while those without the disorder were free of cancer for approximately 49 months – nearly a year longer. Ultimately, those women with ovarian cancer who also had thrombocytosis lived 15 months less than those who did not have the disorder prior to surgery.
“Now that we know that surgery is less likely to remove all the visible cancer in patients with thrombocytosis and that these patients’ cancers are more likely to recur, we can individualize their treatments or use experimental therapies, which may improve their long-term survival,” said Dr. Karlan.
Cedars-Sinai Medical Center is one of the largest non-profit academic medical centers in the Western United States. For the fifth straight two-year period, Cedars-Sinai has been named Southern California's gold standard in health care in an independent survey. Cedars-Sinai is internationally renowned for its diagnostic and treatment capabilities and its broad spectrum of programs and services, as well as breakthroughs in biomedical research and superlative medical education.
Named one of the 100 "Most Wired" hospitals in health care in 2001, the Medical Center ranks among the top 10 non-university hospitals in the nation for its research activities.
For media information and to arrange an interview, please contact Kelli Stauning via e-mail at kelli.stauning@cshs.org, or call 310-423-3674.