Clinical significance for combined coagulation indexes in epithelial ovarian cancer prognosis.
Coagulation system
Epithelial ovarian cancer
Prognostic value
Risk stratification
Journal
Journal of ovarian research
ISSN: 1757-2215
Titre abrégé: J Ovarian Res
Pays: England
ID NLM: 101474849
Informations de publication
Date de publication:
17 Aug 2021
17 Aug 2021
Historique:
received:
23
04
2021
accepted:
07
08
2021
entrez:
18
8
2021
pubmed:
19
8
2021
medline:
11
2
2022
Statut:
epublish
Résumé
Increasing evidence supported an association between cancer and coagulation system. We aimed to identify prognostic values of coagulation biomarkers in epithelial ovarian cancer (EOC). A retrospective study was conducted on patients who underwent optimal tumor debulking followed by platinum-based chemotherapy at our institution. The predictive value of coagulation variables was evaluated by receiver operating characteristic (ROC) curves. Through Cox hazards regression models, prognostic factors were determined for recurrence-free survival (RFS) and overall survival (OS). Survival curves were visualized by Kaplan-Meier method and compared through Log-rank analysis. We involved 482 EOC patients and followed up for 64 (range, 36-87) months. According to ROC curves, D-dimer and International normalized ratio (INR) had superior predictive value than other coagulation indexes, with area under curve (AUC) of 0.758 and 0.742. Patients were then stratified into three combined D-dimer and INR (DD-INR) groups based on the cut-off value of 0.97 mg/L and 0.86, respectively. Through regression analysis, we demonstrated that age (HR 1.273; 95%CI 1.048-2.047; p = 0.045), pathological grade (HR 1.419; 95% CI 1.102-2.491; p = 0.032), clinical stage (HR 2.038; 95%CI 1.284-3.768; p = 0.008), CA-125 (HR 1.426; 95%CI 1.103-1.894; p = 0.038) and DD-INR (HR 2.412; 95%CI 1.683-3.241; p = 0.009) were independent prognostic factors. Survival analysis showed that patients with higher DD-INR experienced poor survival (p = 0.0013 for RFS and p = 0.0068 for OS). Further subgroup analysis revealed that evaluated DD-INR was significantly associated with poor survival among patients with advanced stage (p = 0.0028 for RFS and p = 0.0180 for OS). Our findings suggested that coagulation indexes, especially the combined DD-INR were promising biomarkers for prognosis stratification in EOC patients, especially those with advanced clinical stages.
Sections du résumé
BACKGROUND
BACKGROUND
Increasing evidence supported an association between cancer and coagulation system. We aimed to identify prognostic values of coagulation biomarkers in epithelial ovarian cancer (EOC).
METHODS
METHODS
A retrospective study was conducted on patients who underwent optimal tumor debulking followed by platinum-based chemotherapy at our institution. The predictive value of coagulation variables was evaluated by receiver operating characteristic (ROC) curves. Through Cox hazards regression models, prognostic factors were determined for recurrence-free survival (RFS) and overall survival (OS). Survival curves were visualized by Kaplan-Meier method and compared through Log-rank analysis.
RESULTS
RESULTS
We involved 482 EOC patients and followed up for 64 (range, 36-87) months. According to ROC curves, D-dimer and International normalized ratio (INR) had superior predictive value than other coagulation indexes, with area under curve (AUC) of 0.758 and 0.742. Patients were then stratified into three combined D-dimer and INR (DD-INR) groups based on the cut-off value of 0.97 mg/L and 0.86, respectively. Through regression analysis, we demonstrated that age (HR 1.273; 95%CI 1.048-2.047; p = 0.045), pathological grade (HR 1.419; 95% CI 1.102-2.491; p = 0.032), clinical stage (HR 2.038; 95%CI 1.284-3.768; p = 0.008), CA-125 (HR 1.426; 95%CI 1.103-1.894; p = 0.038) and DD-INR (HR 2.412; 95%CI 1.683-3.241; p = 0.009) were independent prognostic factors. Survival analysis showed that patients with higher DD-INR experienced poor survival (p = 0.0013 for RFS and p = 0.0068 for OS). Further subgroup analysis revealed that evaluated DD-INR was significantly associated with poor survival among patients with advanced stage (p = 0.0028 for RFS and p = 0.0180 for OS).
CONCLUSION
CONCLUSIONS
Our findings suggested that coagulation indexes, especially the combined DD-INR were promising biomarkers for prognosis stratification in EOC patients, especially those with advanced clinical stages.
Identifiants
pubmed: 34404438
doi: 10.1186/s13048-021-00858-1
pii: 10.1186/s13048-021-00858-1
pmc: PMC8369735
doi:
Substances chimiques
Blood Coagulation Factors
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
106Subventions
Organisme : National Natural Science Foundation of China
ID : 81572560
Organisme : National Natural Science Foundation of China
ID : 82072866
Informations de copyright
© 2021. The Author(s).
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