This study aimed to investigate the relationship between thrombocytosis and clinicopathological factors in patients with epithelial ovarian cancer.

This cross-sectional comparative study was conducted at the Department of Gynecological Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from January to December 2019. The study included 94 histopathologically confirmed epithelial ovarian cancer patients (aged 18–70) who underwent primary surgery. Subjects were grouped based on thrombocytosis presence. Pre-operative complete blood count and CA-125 were assessed 7 days before surgery, alongside clinical data collection.

Of the participants, 40 (42.6%) exhibited thrombocytosis with a mean platelet count of 432.21 ± 121.72 (109/L). Thrombocytosis correlated with lower hemoglobin, lower BMI, elevated CA-125 (OR 15.0, 95.0% C.I. 4.92 to 47.72), advanced stage (p = .001), higher-grade tumors (p = .022), more frequent lymph node metastasis (OR 3.03, 95.0% C.I 0.91 to 10.48), and sub-optimal cytoreduction (OR 3.49, 95.0% C.I. 1.33 to 9.28). A significant positive correlation (r = 0.449; p = 0.004) existed between platelet count and ovarian cancer stage. Serum CA-125 levels > 500 U/mL increased thrombocytosis risk by 16.49-fold (95.0% C.I. 3.79 to 71.76).

Thrombocytosis frequently occurs in epithelial ovarian cancer pre-operative evaluations, indicating aggressive tumor biology. Higher CA-125, advanced stage, higher-grade tumors, lymph node metastasis, and sub-optimal cytoreduction are associated with thrombocytosis. Elevated platelet counts predict poorer outcomes, emphasizing the potential utility of platelets as prognostic markers.