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Abstract
Highlights
- •
- Venous thromboembolism (VTE) at the time of primary treatment of ovarian clear cell carcinoma (OCCC) is associated with worse PFS and OS.
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- VTE at the time of primary treatment of OCCC is an independent prognostic factor for death after controlling for stage.
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- The poor prognostic impact of VTE at the time of primary treatment of OCCC is highest in patients with early stage disease.
Objectives
To
determine the impact of venous thromboembolism (VTE) during primary
treatment of ovarian clear cell carcinoma (OCCC) on survival.
Methods
After
Institutional Review Board approval, 74 cases of OCCC were retrieved
from our pathology files. Clinical and pathological data were obtained
by medical record and pathology review. Standard statistical analyses
were performed.
Results
Among 74
patients with OCCC, VTE was diagnosed in 11 (15%) during primary
treatment and 7 (9%) at time of cancer recurrence. 56 (76%) patients
never developed VTE. Patients with VTE during OCCC primary treatment had
shorter progression-free survival (PFS) and overall survival (OS) than
OCCC patients without VTE (median PFS 11 vs. 76 months, p = 0.01, median
OS 19 vs. 90 months, p = 0.001). Patients with VTE during OCCC primary
treatment had a 3.9-fold increase in risk of recurrence (p = 0.007) and a
6.3-fold increase in risk of death (p < 0.001). After controlling
for cancer stage, VTE during OCCC primary treatment remained an
independent prognostic factor for death (HR = 3.6, p = 0.005). No
patient died of VTE.
Conclusions
VTE
during OCCC primary treatment is associated with a significantly higher
risk of cancer recurrence and death. This increased risk is not
attributable to VTE-related mortality and raises the possibility that a
paracrine circuit involving thrombosis might contribute to a more
aggressive tumor biology.
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