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Clinical and Prognostic Significance of Coagulation Assays in Advanced Epithelial Ovarian Cancer

Tas, Faruk MD; Kilic, Leyla MD; Bilgin, Elif PhD; Keskin, Serkan MD; Sen, Fatma MD; Ciftci, Rumeysa MD; Yildiz, Ibrahim MD; Yasasever, Vildan PhD

International Journal of Gynecological Cancer: February 2013 - Volume 23 - Issue 2 - p 276–281
doi: 10.1097/IGC.0b013e31827b8796
Ovarian Cancer

Objective Epithelial ovarian cancer (EOC) is the leading cause of death among gynecological tumors and usually diagnosed at advanced stage. We aimed to identify the clinical and prognostic relevance of coagulation tests and their correlation with serum CA-125 levels in advanced EOC.

Materials and Methods A total of 33 advanced-stage (stages III and IV) EOC patients were enrolled in the study. Of these patients, 17 had received neoadjuvant chemotherapy and 16 patients received chemotherapy after optimal debulking surgery. Several clinicopathologic factors, coagulation assays, routine biochemistry tests, and serum CA-125 levels were evaluated before treatment and compared with healthy subjects.

Results All coagulation tests including prothrombin time (PT), activated partial thromboplastin time, international normalized ratio, fibrinogen, D-dimer, and platelet revealed statistically significant difference between patients and control subjects (P ≤ 0.001). Elevated CA-125 levels were correlated with higher D-dimer values (P = 0.03). Prolonged PT was associated with poorer both overall (P = 0.03) and progression-free survival rates (P = 0.04).

Conclusions Correlation of CA-125 with D-dimer is supposed to reflect hyperactivation of fibrinolytic pathway in the presence of a higher tumor load. Alterations in coagulation pathway reflected by prolonged PT support prognostic effects on survival of advanced-stage EOC patients.

Institute of Oncology, University of Istanbul, Istanbul, Turkey.

Address correspondence and reprint requests to Faruk Tas, MD, Institute of Oncology, University of Istanbul, Capa, 34390 Istanbul, Turkey. E-mail:

The authors declare no conflicts of interest.

Received August 29, 2012

Accepted October 29, 2012

Copyright © 2013 by IGCS and ESGO