Abstract
Previous studies reported inconsistent findings about the relationship between pretreatment thrombocytosis and survival in patients with cervical cancer. This study aimed to evaluate the prognostic significance of thrombocytosis in cervical cancer. We searched databases to identify relevant articles. Pooled hazard ratios (HRs), odds ratios (ORs), and 95% confidence intervals (CIs) were calculated. Fourteen studies including 3,394 patients were eligible for the meta-analysis. Overall, an elevated platelet count was significantly associated with inferior overall survival (OS, hazard ratio [HR]: 1.66, 95% confidence interval [CI]: 1.42–1.95, P < 0.001) and recurrence-free survival (RFS, HR: 1.67, 95% CI: 1.15–2.42, P = 0.007) but not progression-free survival (PFS, HR: 1.21, 95% CI: 0.89–1.64; P = 0.235). The results were similar for low stage patients treated with surgery alone. Moreover, a pretreatment thrombocytosis status was significantly associated with higher clinical stage (odd ratio [OR]: 2.39, 95% CI: 1.68–3.38, P < 0.001), positive pelvic node status (OR: 1.58, 95% CI: 1.01– 2.45, P = 0.044) and larger tumor size (OR: 2.32, 95% CI: 1.39–3.87, P = 0.001). Pretreatment thrombocytosis is an independent prognosis predictor in cervical cancer patients. It may be used as a readily available biomarker to refine clinical outcome prediction for cervical cancer patients.
Highlights
Cervical cancer is the third most normally diagnosed malignance and the fourth leading cause of cancer relevant mortality in females worldwide, with 85% of cases occurring in developing countries, and the peak incidence is in the 40–45 year age group [1]
An elevated platelet count was significantly associated with inferior overall survival (OS, hazard ratio [hazard ratios (HRs)]: 1.66, 95% confidence interval [confidence intervals (CIs)]: 1.42–1.95, P < 0.001) and recurrencefree survival (RFS, HR: 1.67, 95% CI: 1.15–2.42, P = 0.007) but not progressionfree survival (PFS, HR: 1.21, 95% CI: 0.89–1.64; P = 0.235)
Cases with advanced-stage tumor, tumor-related thrombocytosis occurs in 4% to 55% of them either at time of diagnosis or during the process of the disease [22]
Summary
Cervical cancer is the third most normally diagnosed malignance and the fourth leading cause of cancer relevant mortality in females worldwide, with 85% of cases occurring in developing countries, and the peak incidence is in the 40–45 year age group [1]. More and more patients presenting with early stage disease is hypothesized to be the result of the increasingly widespread utilization of multi-parametric imaging, which has lead to an increase in the early detection of cervical malignance. Radical surgery has been the mainstay treatment of early stage cervical cancer, yielding a relatively favorable prognosis [2]. The oncological outcome of advanced or recurrent cervical cancer remains very poor [3]. Www.impactjournals.com/oncotarget numerous tumor markers have been evaluated as potential prognostic predictors, such as tissue polypeptide antigen, squamous cell carcinoma antigen, cancer antigen-125, carcinoembryogenic antigen, and cytokeratin fragment 21–1 [4], it is still difficult to estimate the recurrence risk and outcome in patients with cervical cancer
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