Preoperative thrombocytosis is associated with survival after surgery for colorectal cancer
ABSTRACT OBJECTIVE: To evaluate the influence of preoperative thrombocytosis on survival after surgery in patients with colorectal cancer (CRC). METHODS: Four hundred fifty-three patients who had undergone CRC surgery were retrospectively identified from institutional database. On the basis of receiver operating characteristic (ROC) curve analysis, they were classified into two groups: Group A, with a preoperative platelet count of ≤300 (×10(9) /L), and Group B, with a preoperative platelet count of >300 (×10(9) /L). Uni- and multivariate analyses were performed to evaluate the relationship to overall survival. Kaplan-Meier analysis and log rank test were used to compare the survival curves between groups A and B. RESULTS: There was a significant difference in overall survival between the two groups (P = 0.007). Multivariate analysis of selected preoperative clinicolaboratory characteristics showed that overall survival was associated with the platelet count (Group A/B) (odds ratio, 1.642; 95% CI, 1.025-2.629; P = 0.039) as well as the number of tumors (1/≥2), and the serum levels of C-reactive protein (CRP) and carcinoembryonic antigen (CEA). CONCLUSION: Preoperative thrombocytosis is associated with survival after surgery in CRC patients, and is able to divide such patients into two independent groups before surgery. J. Surg. Oncol © 2012 Wiley Periodicals, Inc.
- SourceAvailable from: Hitoshi Nagata[Show abstract] [Hide abstract]
ABSTRACT: Background: This study investigated the usefulness of a novel inflammation-based prognostic system, named the COP-NLR (COmbination of Platelet count and Neutrophil to Lymphocyte Ratio), for predicting the postoperative survival of patients with colorectal cancer (CRC). Methods: The COP-NLR was calculated on the basis of data obtained on the day of admission: patients with both an elevated platelet count (>30 × 104 mm−3) and an elevated NLR (>3) were allocated a score of 2, and patients showing one or neither were allocated a score of 1 or 0, respectively. Results: Four-hundred and eighty patients were enrolled. Multivariate analysis of clinical characteristics selected by univariate analysis showed that the COP-NLR (1, 2/0) (odds ratio, 0.464; 95% confidence interval, 0.267–0.807; P=0.007) had an association with cancer-specific survival, along with pathology, lymph node metastasis, the serum levels of carcinoembryonic antigen, C-reactive protein and albumin, and the Glasgow Prognostic Score. Kaplan–Meier analysis and log-rank test revealed that the COP-NLR was able to divide such patients into three independent groups (P<0.001). Conclusion: The COP-NLR is considered to be a useful predictor of postoperative survival in patients with CRC.British Journal of Cancer 07/2013; 109(2). DOI:10.1038/bjc.2013.350 · 4.82 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: A growing body of evidence supports a role for thrombocytosis in the promotion of epithelial ovarian cancer biology. However, studies have only linked preoperative platelet count at time of initial cytoreductive surgery to clinical outcome. Here, we sought to determine the impact of elevated platelet count at time of secondary cytoreductive surgery (SCS) for recurrent disease. Under an IRB-approved protocol, we identified 107 women with invasive epithelial ovarian cancer who underwent SCS between January 1997 and June 2012. We reviewed clinical, laboratory, and pathologic records from this retrospective cohort. The data was analyzed using the chi-squared, Fisher's exact, Cox proportional hazards, and Kaplan-Meier tests. We defined thrombocytosis as a platelet count≥350×10^9/L and optimal resection at SCS as microscopic residual disease. Thirteen of 107 women (12%) with recurrent ovarian cancer had thrombocytosis prior to SCS. Preoperative thrombocytosis at SCS was associated with failure to undergo optimal resection (p=0.0001). Women with preoperative thrombocytosis at time of SCS demonstrated shorter overall survival (33months) compared to those with normal platelet counts (46months, p=0.004). On multivariate analysis, only preoperative platelet count retained significance as an independent prognostic factor (p=0.025) after controlling for age at SCS (p=0.90), disease free interval from primary treatment (0.06), and initial stage of disease (0.66). Elevated platelet count at time of SCS is associated with suboptimal resection and shortened overall survival. These data provide further evidence supporting a plausible role for thrombocytosis in aggressive ovarian tumor biology.Gynecologic Oncology 01/2014; 131(1). DOI:10.1016/j.ygyno.2014.01.003 · 3.69 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Thrombocytosis is an adverse prognostic factor in many types of cancer. These include breast cancer, ovarian and other gynecologic cancers, renal cell carcinoma and lung cancers. In gastrointestinal cancers of various locations and histologic types, thrombocytosis has been reported in general to be associated with adverse clinical outcomes. Platelet count measurement is well standardized and available in every clinical laboratory, making its use as a prognostic marker practical. This paper will discuss the data on the prognostic value of thrombocytosis in gastrointestinal cancers as well as pathogenic aspects of the association that strengthen the case for its use in clinical prognostication.02/2014; 6(2):34-40. DOI:10.4251/wjgo.v6.i2.34