Clear cell carcinoma of the ovary and venous thromboembolism: a systematic review and meta-analysis

Abstract

Objectives

As the second most common subtype of Epithelial ovarian cancers (EOCs), ovarian clear cell carcinoma (OCCC) is associated with a high rate of cancer-associated thrombosis. Previous studies revealed the wide range prevalence (6–42%) of venous thromboembolism (VTE) among OCCC patients. This study aimed to determine the prevalence of VTE among OCCC patients as well as factors affecting it.

Methods

PubMed, Scopus, Embase, and Cochrane Library databases were searched up to December 12^th, 2022. Studies reporting venous thromboembolic events in women with clear cell carcinoma of the ovary were included. Demographic data, clinical, and paraclinical features of the patients were independently extracted by two reviewers.

Results

Out of the 2254 records, 43 studies were processed for final review. The qualified studies involved 573 VTE cases among 2965 patients with OCCC. The pooled prevalence of VTE among OCCC patients was 21.32% (95%CI=(17.38–25.87)). Most VTE events were reported in Japanese women (26.15%), followed by Americans (24.41%) and UK (21.57%), and Chinese (13.61%) women. VTE was more common in patients with advanced stages (37.79%) compared to those with early stages of the disease (16.54%).

Conclusions

Ovarian clear cell carcinoma is associated with a high rate of cancer-associated thrombosis. VTE events in OCCC patients were higher in advanced stages and Japanese women.

Keywords:

• Clear cell adenocarcinoma
• venous thrombosis
• thromboembolism
• ovarian epithelial carcinoma
• deep vein thrombosis

Transparency

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

S.Ramezani, K.Namakin collected the data. A.Sheidaei and K.Gohari analyzed data and interpreted the results. H.Najafiarab conceptualized the study, interpreted the results, and critically reviewed the manuscript. F. Farzaneh designed the study and reviewed the final approval of the version to be published. H. Didar, designed the study, interpreted the results, and drafted the manuscript. All authors agreed to be accountable for all aspects of the work.

Acknowledgements

The authors appreciate Dr. Amirreza Keyvanfar for his collaboration in editing the manuscript.

Additional information

Funding

This paper was not funded.