A N Coosemans1,2, Thais Baert2,3, Victoria D'Heygere2,4, Roxanne Wouters2, Lara DE Laet5, Anais VAN Hoylandt2, Gitte Thirion2, Jolien Ceusters2, Annouschka Laenen6, Vincent Vandecaveye7,8, Ignace Vergote5,2,9. 1. Department of Gynecology and Obstetrics, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium an.coosemans@kuleuven.be. 2. Department of Oncology, Leuven Cancer Institute, Laboratory of Tumor Immunology and Immunotherapy, ImmunOvar Research Group, KU Leuven, Leuven, Belgium. 3. Department of Gynecology and Gynecologic Oncology, Kliniken Essen Mitte (KEM), Essen, Germany. 4. Ear, Nose, and Throat Clinic, Uniklinik Essen, Essen, Germany. 5. Department of Gynecology and Obstetrics, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium. 6. Biostatistics and Statistical Bioinformatics Centre of Leuven, Leuven, Belgium. 7. Department of Radiology, University Hospitals Leuven, Leuven, Belgium. 8. Department of Imaging and Pathology, KU Leuven, Leuven, Belgium. 9. Department of Oncology, Leuven Cancer Institute, Laboratory of Gynecologic Oncology, ImmunOvar Research Group, KU Leuven, Leuven, Belgium.
Abstract
BACKGROUND/AIM: The presence of ascites in ovarian cancer patients is considered a negative prognostic factor. The underlying mechanisms are not clearly understood. MATERIALS AND METHODS: The amount of ascites was evaluated, preferably, using diffusion-weighted MRI at primary diagnosis in a retrospective cohort of 214 women with ovarian cancer, in an ordinal manner (amount of ascites: none, limited, moderate, abundant). In a prospective cohort comprising 45 women with ovarian cancer, IL-10 (interleukin), VEGF (vascular endothelial growth factor), TGF-β (transforming growth factor) and CCL-2 [chemokine (C-C) motif ligand 2] were measured at diagnosis (and at interval debulking, when available). RESULTS: Gradually increasing amounts of ascites were correlated significantly, even after correction for FIGO stage, with reduced survival (p<0.0001) and stronger immunosuppression (IL10 and VEGF). Neoadjuvant chemotherapy reduced immunosuppression, which was observed as a reduction in CCL-2, IL-10 and VEGF. CONCLUSION: The amount of ascites is an independent predictor of survival and correlates with increased immunosuppression. Copyright
BACKGROUND/AIM: The presence of ascites in ovarian cancerpatients is considered a negative prognostic factor. The underlying mechanisms are not clearly understood. MATERIALS AND METHODS: The amount of ascites was evaluated, preferably, using diffusion-weighted MRI at primary diagnosis in a retrospective cohort of 214 women with ovarian cancer, in an ordinal manner (amount of ascites: none, limited, moderate, abundant). In a prospective cohort comprising 45 women with ovarian cancer, IL-10 (interleukin), VEGF (vascular endothelial growth factor), TGF-β (transforming growth factor) and CCL-2 [chemokine (C-C) motif ligand 2] were measured at diagnosis (and at interval debulking, when available). RESULTS: Gradually increasing amounts of ascites were correlated significantly, even after correction for FIGO stage, with reduced survival (p<0.0001) and stronger immunosuppression (IL10 and VEGF). Neoadjuvant chemotherapy reduced immunosuppression, which was observed as a reduction in CCL-2, IL-10 and VEGF. CONCLUSION: The amount of ascites is an independent predictor of survival and correlates with increased immunosuppression. Copyright