Preoperative thrombocytosis as a prognostic factor in endometrioid-type endometrial carcinoma.

Abstract

BACKGROUNDThe impact of preoperative thrombocytosis as a prognostic factor in endometrial carcinoma (EC) remains uncertain and has never been examined in Saudi Arabia.OBJECTIVESTo determine the prevalence of preoperative thrombocytosis (platelet count >400 000/μL), and its prognostic significance for clinicopathological factors and survival in Saudi patients with endometrioid-type EC.DESIGNA retrospective cross-sectional study from January 2010 to December 2013.SETTINGA referral tertiary healthcare institute.PATIENTS AND METHODSPatients who underwent staging surgery for primary endometrioid-type EC were retrospectively analyzed for perioperative details: age, preoperative platelet count, International Federation of Gynecology and Obstetrics (FIGO) stage, endometrioid grade, recurrence, disease-free survival (DFS) and overall survival (OS). Survival analysis was conducted using Kaplan-Meier estimates and a Cox proportional hazards model.MAIN OUTCOME MEASURESPrevalence of preoperative thrombocytosis, DFS and OS. RESULTS: In 162 patients who met inclusion criteria, the frequency of preoperative thrombocytosis was 8.6% (n=14). Patients with advanced FIGO disease (stages III–IV) and recurrence had significantly higher mean preoperative platelet counts than patients with early FIGO disease (stages I–II) and no recurrence (P=.0080 and P=.0063, respectively). Patients with thrombocytosis had statistically significant higher rates of advanced FIGO stages III–IV disease, unfavorable grades II–III endometrioid histology and recurrence than patients with preoperative platelet counts ≤400 000/μL (P<.001, P<.0105 and P<.001, respectively). In a univariate analysis, patients with preoperative thrombocytosis had statistically lower mean DFS and OS rates than patients without thrombocytosis (P<.0001 and P<.0001, respectively). In a multivariate analysis, thrombocytosis was not an independent prognostic factor of DFS and OS.CONCLUSIONThe frequency of preoperative thrombocytosis is not uncommon. Also, preoperative thrombocytosis is associated with poor clinicopathological prognostic factors, and poor survival outcomes in a univariate but not multivariate analysis.LIMITATIONThe retrospective study design, sample size and lack of exploration of other clinicopathological factors.