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Venous thromboembolism, interleukin-6 and survival outcomes in patients with advanced ovarian clear cell carcinoma

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Title: Venous thromboembolism, interleukin-6 and survival outcomes in patients with advanced ovarian clear cell carcinoma
Authors: Matsuo, K
Hasegawa, K
Yoshino, K
Murakami, R
Hisamatsu, T
Stone, RL
Previs, RA
Hansen, JM
Ikeda, Y
Miyara, A
Hiramatsu, K
Enomoto, T
Fujiwara, K
Matsumura, N
Konishi, I
Roman, LD
Gabra, H
Fotopoulou, C
Sood, AK
Item Type: Journal Article
Abstract: Background: We compared survival outcomes and risk of venous thromboembolism (VTE) among patients with advanced and early-stage ovarian clear cell carcinoma (OCCC) and serous ovarian carcinoma (SOC), as well as potential links with interleukin-6 (IL-6) levels. Methods: A multicenter case-control study was conducted in 370 patients with OCCC and 938 with SOC. In a subset of 200 cases, pretreatment plasma IL-6 levels were examined. Findings: Patients with advanced OCCC had the highest 2-year cumulative VTE rates (advanced OCCC 43.1%, advanced SOC 16.2%, early-stage OCCC 11.9% and early-stage SOC 6.4%, P < 0.0001) and the highest median levels of IL-6 (advanced OCCC 17.8 pg/mL, advanced SOC 9.0 pg/mL, early-stage OCCC 4.2 pg/mL and early-stage SOC 5.0 pg/mL, P = 0.006). Advanced OCCC (hazard ratio [HR] 3.38, P < 0.0001), thrombocytosis (HR 1.42, P = 0.032) and elevated IL-6 (HR 8.90, P = 0.046) were independent predictors of VTE. In multivariate analysis, patients with advanced OCCC had significantly poorer 5-year progression-free and overall survival rates than those with advanced SOC (P < 0.01), and thrombocytosis was an independent predictor of decreased survival outcomes (P < 0.01). Elevated IL-6 levels led to poorer 2-year progression-free survival rates in patients with OCCC (50% versus 87.5%, HR 4.89, P = 0.016) than in those with SOC (24.9% versus 40.8%, HR 1.40, P = 0.07). Interpretation: Advanced OCCC is associated with an increased incidence of VTE and decreased survival outcomes, which has major implications for clinical management of OCCC.
Issue Date: 31-Jul-2015
Date of Acceptance: 13-Jul-2015
URI: http://hdl.handle.net/10044/1/43689
DOI: https://dx.doi.org/10.1016/j.ejca.2015.07.012
ISSN: 1879-0852
Publisher: Elsevier
Start Page: 1978
End Page: 1988
Journal / Book Title: European Journal of Cancer
Volume: 51
Issue: 14
Copyright Statement: © 2015 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
Ovarian cancer
Clear cell carcinoma
Venous thromboembolism
IL-6
Survival outcome
EPITHELIAL OVARIAN
2-TIER SYSTEM
CANCER
CYTOKINE
EXPRESSION
MICROENVIRONMENT
THROMBOSIS
Adult
Aged
Biomarkers, Tumor
Carcinoma
Disease Progression
Disease-Free Survival
Female
Humans
Incidence
Interleukin-6
Japan
Kaplan-Meier Estimate
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local
Neoplasm Staging
Neoplasms, Cystic, Mucinous, and Serous
Ovarian Neoplasms
Proportional Hazards Models
Retrospective Studies
Risk Factors
Time Factors
United States
Up-Regulation
Venous Thromboembolism
Tumor Markers, Biological
Oncology & Carcinogenesis
1112 Oncology And Carcinogenesis
Publication Status: Published
Appears in Collections:Division of Surgery
Division of Cancer
Faculty of Medicine



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