Abstract
BackgroundThe prognostic value of elevated pretreatment platelet counts remains controversial in lung cancer patients. We performed the present meta-analysis to determine its precise role in these patients.MethodsWe employed a multiple search strategy in the PubMed, EMBASE and Cochrane Library databases to identify eligible studies. Disease-free survival (DFS)/progression-free survival (PFS)/time to progression (TTP) and overall survival (OS) were used as outcomes with hazard ratios (HRs) and 95% confidence intervals (CIs). Heterogeneity among the studies and publication bias were also evaluated.ResultsA total of 40 studies including 16,696 lung cancer patients were eligible for the analysis. Overall, the pooled analysis showed that compared with normal platelet counts, elevated pretreatment platelet counts were associated with poorer OS (HR = 1.54, 95% CI: 1.37–1.72, P < 0.001) and poorer DFS/PFS/TTP (HR = 1.62, 95% CI: 1.33–1.98, P < 0.001) in patients with lung cancer. In subgroup analyses, elevated pretreatment platelet counts were also associated with poorer OS and DFS/PFS/TTP in most subgroups. There was no evidence of publication bias.ConclusionsThis meta-analysis revealed that elevated pretreatment platelet counts were an independent predictor of OS and DFS/PFS/TTP in lung cancer patients. Large-scale prospective studies and a validation study are warranted.
Highlights
The prognostic value of elevated pretreatment platelet counts remains controversial in lung cancer patients
Exclusion criteria Articles were excluded if they met the following criteria: (1) articles were reviews, case reports, letters, editorials, or conference abstracts; (2) articles that were not written in English; (3) articles missing key information for evaluating the Hazard ratio (HR) and its 95% confidence intervals (CIs); (4) studies based on cancer cells or animal models and irrelevant studies; and (5) studies by the same authors with similar or overlapping data
The results indicate that elevated platelet counts were associated with poorer overall survival (OS) in lung cancer patients (HR = 1.54, 95% CI: 1.37–1.72, P < 0.001, Fig. 2a)
Summary
The prognostic value of elevated pretreatment platelet counts remains controversial in lung cancer patients. Non-small-cell lung cancer (NSCLC), the leading type of lung cancer, accounts for 80% of all cases. Various therapies, such as surgery, radiotherapy, chemotherapy, targeted therapy, and the rising immunization therapy have emerged, they exhibit limited effects on lung cancer, and the prognosis of patients remains unsatisfactory, with five-year survival rates of 6.3%. In the 1960s, Richard B. et al suggested that platelets were correlated with cancer [5]. Increasing evidence has indicated that platelet count correlates with prognosis in various malignancies, such as lung, renal, gastric, colorectal and hepatocellular cancer and is considered a hallmark of
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