Post-splenectomy thrombocytosis and survival outcomes of patients submitted to maximal effort cytoreductive surgery for advanced epithelial ovarian cancer

Background: Splenectomy is a very common procedure that is frequently necessary in cases requiring upper abdominal surgery for ovarian cancer. To date, the impact of postoperative thrombocytosis on ovarian cancer survival has not been studied. In the present retrospective cohort study we chose to evaluate the impact of post-splenectomy thrombocytosis on survival outcomes of patients with advanced epithelial ovarian cancer that were submitted to maximal effort cytoreductive procedures. Methods: We conducted a retrospective cohort study based on cases that had major debulking procedures, involving upper abdominal surgery for epithelial ovarian cancer. Results: Overall, 82 women had splenectomy of whom, 52 (63%) developed thrombocytosis. The results of the univariate analysis revealed that postoperative thrombocytosis did not increase the risk of disease recurrence (62.94 months (31.71, 93.27) vs 31.40 months (21.39, 41.41) log-rank=.683). Similar results were obtained for overall survival of included patients which was comparable among the two groups (87.50 months (53.47, 121.52) vs 47.78 months (34.30, 61.25), log-rank=.511). Logistic regression analysis revealed that only age was a predictive factor of postoperative thrombocytosis with an effect of minimal clinical importance (OR 0.94, 95% CI 0.89, 1.00). Conclusion: Post-splenectomy thrombocytosis does not affect the survival outcomes of patients with advanced epithelial ovarian cancer that undergo major debulking procedures. This might be explained by the underlying mechanisms which in the case of postoperative thrombocytosis seem to be completely disconnected from the pathophysiology of cancer.