Reciprocal links between venous thromboembolism, coagulation factors and ovarian cancer progression

Thromb Res. 2017 Feb:150:8-18. doi: 10.1016/j.thromres.2016.12.002. Epub 2016 Dec 14.


Ovarian cancer is the most lethal gynecological malignancy, which is due to late presentation. Treating advanced stage ovarian cancer is difficult, and tumor recurrence and chemoresistance frequently occur. In addition, early detection remains a major challenge as there are no early warning signs and no appropriate biomarkers. To reduce mortality rates of ovarian cancer patients, novel drug targets and biomarkers are needed. We postulate that hemostatic keyplayers are of importance when combatting ovarian cancer. The majority of ovarian cancer patients have abnormal hemostatic blood serum marker levels, which indicate an activated coagulation system. This makes patients more prone to experiencing venous thromboembolism (VTE), and the occurrence of VTE in ovarian cancer patients adversely affects survival. Coagulation activation also promotes tumor progression as it influences tumor biology at several stages and the decreased survival rates associated with ovarian cancer-associated thrombosis are more likely due to cancer metastasis rather than to fatal thromboembolic events. In this review, we will discuss; (1) Population studies that address the bidirectional relationship between VTE and ovarian cancer, and the most important risk factors involved; (2) The mechanisms of coagulation factors and platelets that are critically involved in the development of VTE, and the progression of ovarian cancer; (3) Roles and future directions of coagulation factors in ovarian cancer therapy, and in diagnosis and prognosis of ovarian cancer as biomarkers.

Keywords: Blood coagulation; Metastasis; Platelets; Protease-activated receptors; Thrombin; Tissue factor.

Publication types

  • Review

MeSH terms

  • Animals
  • Blood Coagulation
  • Blood Coagulation Factors / analysis
  • Blood Coagulation Factors / metabolism*
  • Blood Platelets / pathology*
  • Disease Progression
  • Female
  • Humans
  • Ovarian Neoplasms / blood*
  • Ovarian Neoplasms / complications*
  • Ovarian Neoplasms / metabolism
  • Ovarian Neoplasms / pathology
  • Ovary / pathology*
  • Prognosis
  • Risk Factors
  • Venous Thromboembolism / blood*
  • Venous Thromboembolism / etiology*
  • Venous Thromboembolism / metabolism
  • Venous Thromboembolism / pathology


  • Blood Coagulation Factors