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

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.

• Authors: Koji Matsuo, Kosei Hasegawa, Kiyoshi Yoshino, Ryusuke Murakami, Takeshi Hisamatsu, Rebecca L Stone, Rebecca A Previs, Jean M Hansen, Yuji Ikeda, Akiko Miyara, Kosuke Hiramatsu, Takayuki Enomoto, Keiichi Fujiwara, Noriomi Matsumura, Ikuo Konishi, Lynda D Roman, Hani Gabra, Christina Fotopoulou, Anil K Sood
• Journal: European journal of cancer (Oxford, England : 1990) (Eur J Cancer) Vol. 51 Issue 14 Pg. 1978-88 (Sep 2015) ISSN: 1879-0852 [Electronic] England
• PMID: 26238017 (Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
• Copyright: Copyright © 2015 Elsevier Ltd. All rights reserved.

Chemical References

• Biomarkers, Tumor
• IL6 protein, human
• Interleukin-6

Topics

• Adult
• Aged
• Biomarkers, Tumor (blood)
• Carcinoma (blood, complications, mortality, pathology)
• Disease Progression
• Disease-Free Survival
• Female
• Humans
• Incidence
• Interleukin-6 (blood)
• Japan
• Kaplan-Meier Estimate
• Middle Aged
• Multivariate Analysis
• Neoplasm Recurrence, Local
• Neoplasm Staging
• Neoplasms, Cystic, Mucinous, and Serous (blood, complications, mortality, pathology)
• Ovarian Neoplasms (blood, complications, mortality, pathology)
• Proportional Hazards Models
• Retrospective Studies
• Risk Factors
• Time Factors
• United States
• Up-Regulation
• Venous Thromboembolism (diagnosis, etiology, mortality)