Abstract
ObjectiveThe mean platelet volume/platelet count (MPV/PC) ratio is an emerging biomarker in selected types of cancer. The objective of this study is to analyze the association of MPV/PC ratio with progression and survival in glioblastoma (GB) patients, with consideration of patient demographics, tumor morphology, extent of resection, molecular pathology, and oncological therapy.MethodsOne hundred ninety-one patients with newly diagnosed GB were analyzed retrospectively. MPV/PC ratio groups (≤ or >0.0575) were dichotomized into low-MPV/PC ratio (≤0.0575) and high-MPV/PC ratio (>0.0575) groups according to the most significant split in the log-rank test.ResultsA two-sided Fisher’s exact test showed no significant differences in the confounders between the low- and high-MPV/PC ratio groups. The median progression-free survival (PFS) was 9.0 months (95% CI=8.0–10.0) in the low-MPV/PC ratio group (n=164) and 6.0 months (95% CI=3.0–8.9) in the high-MPV/PC group (n=28) (p=0.013). Multivariate Cox regression analysis including the O-6-methylguanine-DNA methyltransferase (MGMT) status, age (≤/>65 years), baseline Karnofsky Performance Status (KPS), and MPV/PC ratio showed high-MPV/PC ratio as a predictor of progression (p =0.04, HR=1.61, 95% CI=1.01–2.57). In the subgroup of IDH1 wild-type GBs, high MPV/PC ratio was still a significant predictor for shortened PFS (p=0.042, HR=1.60, 95% CI=1.02–2.52). MPV/PC ratio showed no significant effect in the overall survival (OS) analysis. Median OS was 15.0 months in the high-MPV/PC ratio group and 21.0 months in the low-MPV/PC ratio group (p=0.22).ConclusionMPV/PC ratio may independently predict the progression-free survival rates of patients with glioblastoma multiforme.
Highlights
Glioblastoma (GB) remains a fatal disease with low survival rates, accounting for 15.8% of all brain and central nervous system (CNS) tumors [1]
The median progression-free survival (PFS) was 9.0 months in the low-mean platelet volume/platelet count (MPV/platelet count (PC)) ratio group (n=164) and 6.0 months in the high-Mean platelet volume (MPV)/PC group (n=28) (p=0.013)
Multivariate Cox regression analysis including the O-6-methylguanine-DNA methyltransferase (MGMT) status, age (≤/>65 years), baseline Karnofsky Performance Status (KPS), and MPV/PC ratio showed high-MPV/PC ratio as a predictor of progression (p =0.04, hazard ratio (HR)=1.61, 95% CI=1.01–2.57)
Summary
Glioblastoma (GB) remains a fatal disease with low survival rates, accounting for 15.8% of all brain and central nervous system (CNS) tumors [1]. Standard treatment includes microsurgical resection with functional preservation followed by concomitant radiochemotherapy, with a strong positive correlation between the extent of resection (EOR) and prolonged overall survival/progression-free survival (PFS) [9, 10]. The prognostic benefits and importance of a concomitant radiochemotherapy regimen including temozolomide (TMZ) or lomustine-TMZ are evident [6, 11]. The potential role of platelet–immune cell interaction and its specific role in glioma resistance and tumor progression were recently debated. The known interaction between immune cells and platelets necessitates the elucidation of new and potential platelet biomarkers for upcoming and promising immunotherapeutic approaches [12]
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