International Journal of Clinical Oncology

, Volume 24, Issue 10, pp 1273–1283 | Cite as

Thrombotic events induce the worse prognosis in ovarian carcinomas and frequently develop in ovarian clear cell carcinoma

  • Kazuki Takasaki
  • Morikazu MiyamotoEmail author
  • Masashi Takano
  • Hiroaki Soyama
  • Tadashi Aoyama
  • Hiroko Matsuura
  • Hideki Iwahashi
  • Hiroki Ishibashi
  • Takahiro Sakamoto
  • Kenichi Furuya
Original Article



This study aimed to examine the clinical significance and risk factors of thromboembolic events (TEEs) in patients with ovarian carcinoma.


Patients with ovarian carcinoma treated at our hospital between 2000 and 2017 were identified. The risk factors of TEEs, including venous TEEs and arterial TEEs, and the association between TEEs and prognosis were investigated. Patients with TEEs were classified into two groups: those with severe TEEs, defined as patients who required urgent treatment for deep vein thrombosis, massive pulmonary embolism, acute myocardial infarction, and symptomatic cerebral infarction, and those with mild TEEs. The risk factors of severe TEEs and the association between severe TEEs and prognosis were investigated.


A total of 369 patients were enrolled. Among them, 53 patients (14.4%) were complicated with TEEs. Clear cell carcinoma (CCC) was a greater risk factor of TEEs than serous carcinoma (hazard ratio [HR] = 2.81, p = 0.03). In multivariate analysis for survival, TEEs were a prognostic factor of poor progression-free survival (PFS; HR = 2.90, p < 0.01) and overall survival (OS; HR = 2.89, p < 0.01). Among 53 patients with TEEs, 17 (32.1%) developed severe TEEs. CCC was strongly associated with severe TEEs (HR = 42.6, p = 0.02). Multivariate analysis for survival demonstrated that severe TEEs were a risk factor of worse PFS (HR = 4.34, p < 0.01) and OS (HR = 3.30, p = 0.03).


TEEs induced poor prognosis and was associated with CCC. A standard treatment for CCC should be included in the strategy of TEEs.


Ovarian cancer Thromboembolic events Venous thromboembolism Arterial thromboembolism Clear cell carcinoma 




Compliance with ethical standards

Conflicts of interest

All authors declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

Informed consent was not obtained because our study was a retrospective analysis.


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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Kazuki Takasaki
    • 1
  • Morikazu Miyamoto
    • 1
    Email author
  • Masashi Takano
    • 2
  • Hiroaki Soyama
    • 1
  • Tadashi Aoyama
    • 1
  • Hiroko Matsuura
    • 1
  • Hideki Iwahashi
    • 1
  • Hiroki Ishibashi
    • 1
  • Takahiro Sakamoto
    • 1
  • Kenichi Furuya
    • 1
  1. 1.Department of Obstetrics and GynecologyNational Defense Medical College HospitalTokorozawaJapan
  2. 2.Department of Clinical OncologyNational Defense Medical College HospitalTokorozawaJapan

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