Poor prognosis associated with venous thromboembolism in Asian patients with ovarian clear cell carcinoma

Abstract

Purpose of Investigation: To evaluate the incidence and prognostic implications of venous thromboembolism (VTE) in Asian patients with ovarian clear cell carcinoma (CCC). Materials and Methods: Between July 1987 and December 2005, 144 CCC patients were identified. The clinical outcomes of those with (case) and without (control) VTE were analyzed retrospectively. Results: After a mean follow-up of 131.2 ± 52.2 months, 11.1% (16/144) developed VTE and only one occurred in the perioperative period. Compared to the control, the case group was less responsive to chemotherapy (57.1% vs. 85.1%, p = 0.01) with shorter duration of response to chemotherapy (4.7 months vs. 83.6 months; p < 0.001), higher recurrence / progressive disease rate (100.0% vs. 37.2%, p < 0.001), shorter median disease-free survival (DFS) (0 months vs. 70.8 months; p < 0.001), and overall survival (OS) (16.5 months vs. 88.0 months; p < 0.001). The median interval from the diagnosis of VTE to death was 43.0 (range 1–394) days, and the 60-day mortality rate was 56.3%. Multivariate analysis showed that duration of chemotherapy response for more than one year was independently correlated with the DFS, while VTE, stage, and the chemotherapy response duration were independent prognosticators for OS. Conclusion: VTE is rare in Asian patients with CCC and care is needed when giving it to these patients in view of possible haemorrhagic complications. When VTE occurs, it is associated with high mortality.