Abstract
This study was performed to analyze the prognostic implications of pretreatment or preoperative thrombocytosis in women with gynecologic malignancies. We surveyed 2 medical databases, PubMed and EMBASE, to identified all relevant studies. A total of 14 (n=3,490) that evaluated the link between thrombocytosis and 5-year survival were included. REVMAN version 5.1 was used for our analysis and publication bias was evaluated using the Begg's funnel plot and tested by STATA 11.0. Risk ratios (RRs) with 95% confidence intervals (CIs) generated by the random effect model were used to assess the strength of any association. 709(20.3%) of the 3,490 patients exhibited thrombocytosis (platelet counts >400?109/L) at primary diagnosis, and their mortality was 1.62-fold higher compared with the others (RR=1.62, 95%CI= [1.28- 2.05], p<0.0001). Thrombocytosis failed to have a stronger effect on the survival of advanced patients of stages III to IV in our study (n=478, RR=1.29, 95% CI= [1.13-1.48], p=0.0003), nor in women with cervical cancer in stage IB (n=1371, RR= 1.73, 95% CI= [1.71-2.58], p=0.007). In addition, when adjusted for different carcinoma, it was associated with worse prognosis for all except the ones with vulvar cancer (n=201, RR= 0.43, 95% CI= [0.14-1.29], p=0.13). This meta-analysis indicated that thrombocytosis might be associated with a worse prognosis for patients with gynecologic malignancies but without specificity or sensitivity for the ones in advanced stage. When adjusted for different gynecologic malignancies, it showed a significant effect on survival of all except vulvar cancers.
Highlights
Materials and MethodsThe clinical observation of thrombocytosis and malignancies was described over a century ago (Trousseau et al, 1867; Riess et al, 1872)
Eligible Studies Our electronic search algorithm retrieved a total of 315 references for pretreatment or preoperative thrombocytosis and gynecologic malignancies, and 22 full texts were evaluated. 20 reports were identified with thrombocytosis in patients with gynecologic malignancies while one of excluded was an editorial for another article included (Rodriguez et al, 1994; Rodriguez et al, 1994) and the other was in German (Zeimet et al, 1993)
We examined the correlation of thrombocytosis with overall survival (OS) before any curative treatment or surgery of gynecologic malignancies
Summary
Materials and MethodsThe clinical observation of thrombocytosis (defined as a platelet counts >400×109/L) and malignancies was described over a century ago (Trousseau et al, 1867; Riess et al, 1872). Up to now, there was no metaanalysis comprehensively analyzing the prognostic value of thrombocytosis in cancer patients. The aim of this study was to comprehensively and quantitatively summarize the evidence for the use of pretreatment or preoperative thrombocytosis to evaluate its prognostic value for women with gynecologic malignancies. This study was performed to analyze the prognostic implications of pretreatment or preoperative thrombocytosis in women with gynecologic malignancies. Thrombocytosis failed to have a stronger effect on the survival of advanced patients of stages III to IV in our study (n=478, RR=1.29, 95% CI= [1.13-1.48], p=0.0003), nor in women with cervical cancer in stage IB (n=1371, RR= 1.73, 95% CI= [1.71-2.58], p=0.007). Conclusions: This meta-analysis indicated that thrombocytosis might be associated with a worse prognosis for patients with gynecologic malignancies but without specificity or sensitivity for the ones in advanced stage. When adjusted for different gynecologic malignancies, it showed a significant effect on survival of all except vulvar cancers
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