Hemostatic and fibrinolytic status in patients with ovarian cancer and benign ovarian cysts: Could D-dimer and antithrombin III levels be included asprognostic markers for survival outcome?

We determined the hemostatic and fibrinolytic status in 60 patients with ov arian cancer and benign ovarian cysts. Hypercoagulation, increased platelet s, and enhanced fibrinolysis were seen in patients with preoperative ovaria n cancer compared to patients with benign ovarian cysts. Enhanced thrombin generation, evidenced by increased F1+2 and decreased antithrombin III (ATI II) levels with further enhanced fibrinolysis by elevated D-dimer, was seen in advanced cancer. Ten ovarian cancer patients died within 13 months afte r diagnosis and another died at 24 months, all from advanced stage of cance r, except one from stage IC cancer who died at 11 months. The survival rate s from the disease at 13 months and 24 months were 66.7% and 45%, respectiv ely. Most of the patients had gone through the complete course of chemother apy, and those patients still alive have been disease free between 13 and 4 2 months. No statistical relationships for the hemostatic parameters studie d in ovarian cancer patients could be found between those who died and thos e still living 13 and 24 months after diagnosis, except for ATIII and D-dim er levels. Elevated D-dimer levels were associated with those who died within 13 and 2 4 months from the disease, and the decreased ATIII levels only reached stat istical significance by 24 months. It could be suggested that these two par ameters might be useful as systemic prognostic markers in survival outcome from the disease for the first 24 months in advanced ovarian cancer, in add ition to the known correlation with the International Federation of Gynecol ogy and Obstetrics stage.