Prognostic Significance Of Thrombocytosis Research Articles

Prognostic Significance of Thrombocytosis in Locally Advanced Carcinoma Cervix Patients Treated with Chemoradiotherapy

Background: The outcome of chemoradiotherapy in patients with locally advanced cervical carcinoma is highly variable and depends on various prognostic factors. Objectives: The aim of this study is to evaluate the prevalence and prognostic significance of thrombocytosis in this group of the patients referred to our institution. Methods: Between January 2008 and December 2012, 195 patients with locally advanced cervical carcinoma (International Federation of Gynecology and Obstetrics (FIGO) stages of IIB-IIIB), treated with external beam radiotherapy (EBRT) to a dose of 45 Gy in 25 fractions along with concurrent chemotherapy (cisplatin 40 mg/m2), followed by HDR brachytherapy EQD2 of 30 Gy. The platelet counts were recorded pre-treatment and during treatment in all the patients. Results: Among the 195 patients, 101 (51.5%) belonged to stage IIB and 94 (48.5%) to stage IIIB. Thrombocytosis (platelet count > 400 × 109/liter) was seen in 31 (15.8%) patients. The overall survival in thrombocytosis group is 41%, which is significantly less than the overall survival of the non-thrombocytosis group, which is 62%. Conclusions: Thrombocytosis is not a frequent finding in patients with locally advanced cervical carcinoma in our population; however, when it is present, it is associated with poor outcome in terms of survival.

Pretreatment thrombocytosis predict poor prognosis in patients with endometrial carcinoma: a systematic review and meta-analysis

BackgroundSeveral previous studies have confirmed that thrombocytosis was related to reduced survival in many solid tumors. However, the prognostic significance of thrombocytosis in endometrial carcinoma (EC) was still controversy. Therefore, we conducted this study to assess the prognostic value of thrombocytosis in EC.MethodsThe database including PubMed, MEDLINE, EMBASE, and Web of Science was searched to explore available literature. Above all, the hazard ratio (HR), odds ratios (OR) with 95% confidence intervals (CIs) was used to investigate the correlation between thrombocytosis and overall survival (OS) and disease-free survival (DFS). Moreover, the association between thrombocytosis and patient clinicopathological characteristics was explored. Publication bias and sensitivity analysis also were conducted in this study.ResultsOverall, 11 studies involving 3439 patients were contained in this study. The results revealed that pretreatment thrombocytosis was significantly related to a decreased OS (pooled HR = 2.99; 95% CI = 2.35–3.8; P < 0.001) and DFS (pooled HR = 2.86; 95% CI = 2.27–3.6; P < 0.001) in patients with EC. Moreover, thrombocytosis was correlated with adverse clinicopathological parameters.ConclusionsPretreatment thrombocytosis is an adverse prognostic marker in patients with EC.

Thrombocytosis and hyperfibrinogenemia are predictive factors of clinical outcomes in high-grade serous ovarian cancer patients.

BackgroundOver 20 % of ovarian cancer patients have preoperative thrombocytosis or hyperfibrinogenemia. We aimed to demonstrate the clinical and prognostic significance of thrombocytosis and hyperfibrinogenemia in high-grade serous ovarian cancer (HGSC).MethodsWe retrospectively investigated HGSC patients who underwent primary staging or debulking surgery between April 2005 and June 2013 in our institution. None of these patients had received neoadjuvant chemotherapy. Data, including age, performance status, FIGO stage, serum CA125, platelet count, fibrinogen level, and surgical residual disease, were collected. Thrombocytosis was defined as a platelet count greater than 450 × 109/L, and hyperfibrinogenemia was defined as a fibrinogen level higher than 4.00 g/L. Progression-free survival (PFS) and overall survival (OS) were analyzed with the Kaplan-Meier method and log-rank tests for univariate analyses. For the multivariate analyses, Cox regression analysis was used to evaluate the effects of the prognostic factors, which are expressed as hazard ratios (HRs).ResultsA total of 875 consecutive HGSC patients were identified. The median follow-up time was 29 (1–115) months. The median (interquartile range, IQR) preoperative platelet count was 301 (235–383) × 109/L, and 121 (13.8 %) women had thrombocytosis. The median (IQR) preoperative fibrinogen level was 3.85 (3.19–4.45) g/L, and 332 (45.9 %) of the patients had hyperfibrinogenemia. Both preoperative thrombocytosis and hyperfibrinogenemia were associated with an advanced FIGO stage (p = 0.008 and <0.001, respectively), an increased CA125 level (p = 0.004 and 0.001, respectively), more extensive ascites (p < 0.001 and <0.001, respectively), more extensive residual disease (p < 0.001 and <0.001, respectively) and chemosensitivity (p = 0.043 and <0.001, respectively). In the univariate analyses, hyperfibrinogenemia was associated with reduced PFS (p < 0.001) and OS (p < 0.001). However, thrombocytosis was not found to be a potential predictor of PFS (P = 0.098) or OS (p = 0.894). In the multivariate analyses, hyperfibrinogenemia was an independent predictor of OS (p = 0.014) but not PFS (p = 0.062).ConclusionPreoperative thrombocytosis and hyperfibrinogenemia reflected tumor burden to some extent and thus influenced treatment outcomes, and the fibrinogen level was found to be useful as a prognostic predictor in the HGSC patients.

The prognostic significance of thrombocytosis in ovarian cancer

Ovarian cancer makes up 25-30% of all cases of cancers of the female genital tract. It has the highest mortality rate of any condition in oncological gynaecology. Early diagnosis is associated with a favourable 5-year survival prognosis. Many solid tumours have been detected with concomitant thrombocytosis. The tumour cell-induced platelet aggregation is a result of a direct integration of tumour cells with blood platelets. The aim of the present paper is an evaluation of platelet count as a prognostic parameter for ovarian cancer. Between 2000 - 2005, 349 patients with ovarian tumour (aged 12 - 88-years-old) underwent primary surgical treatment at a clinic. Ninety-seven patients with ovarian carcinomas underwent chemotherapy in the Oncology Centre. The control group comprised 252 women diagnosed with a histopathological lesion of mild intensity, whereas the cancer group constituted 97 women with a histopathologically-diagnosed malignant neoplasm. Thrombocytopaenia was assumed with a platelet count below 150G/L and thrombocythaemia at 350G/L and higher. Thrombocytosis often coincides with ascites and the cytoreduction decreases platelet count. There is a positive correlation between platelet count and tumour grading. Thrombocytosis was more frequently found in high grade tumours. There is also a positive correlation between platelet count and tumour stage according the International Federation of Gynaecology and Obstetrics (FIGO). Thrombocytosis was more frequently found in stage III and IV cancers. Patients with co-occurring thrombocytosis were found to have shorter survival periods and shorter time free from disease. This seems to give grounds for measuring platelet count before the primary surgical intervention, and suggests that the platelet count should be included in the panel of prognostic factors for patients with ovarian tumours.

Thrombocytosis portends adverse prognostic significance in patients with stage II colorectal carcinoma.

Thrombocytosis portends adverse prognostic significance in many types of cancers including ovarian and lung carcinoma. In this study, we determined the prevalence and prognostic significance of thrombocytosis (defined as platelet count in excess of 400 × 10 3/μl) in patients with colorectal cancer. We performed a retrospective analysis of 310 consecutive patients diagnosed at our Institution between 2004 and 2013. The patients (48.7% male and 51.3% female) had a mean age of 69.9 years (+/- 12.7 years) at diagnosis. Thrombocytosis was found in a total of 25 patients, with a higher incidence in those with stage III and IV disease (14.4% of patients). Although the mean platelet count increased with the depth of tumor invasion (pT), its values remained within normal limits in the whole patient cohort. No patient with stage I cancer (n=57) had elevated platelet count at diagnosis. By contrast, five of the 78 patients (6.4%) with stage II cancer showed thrombocytosis, and four of these patients showed early recurrence and/or metastatic disease, resulting in shortened survival (they died within one year after surgery). The incidence of thrombocytosis increased to 12.2% and 20.6%, respectively, in patients with stage III and IV disease. The overall survival rate of patients with thrombocytosis was lower than those without thrombocytosis in the stage II and III disease groups, but this difference disappeared in patients with stage IV cancer who did poorly regardless of their platelet count. We concluded that thrombocytosis at diagnosis indicates adverse clinical outcome in colorectal cancer patients with stage II or III disease. This observation is especially intriguing in stage II patients because the clinical management of these patients is controversial. If our data are confirmed in larger studies, stage II colon cancer patients with thrombocytosis may be considered for adjuvant chemotherapy.

Thrombocytosis portends adverse prognostic significance in patients with stage II colorectal carcinoma

Thrombocytosis portends adverse prognostic significance in many types of cancers including ovarian and lung carcinoma. In this study, we determined the prevalence and prognostic significance of thrombocytosis (defined as platelet count in excess of 400 K/μl) in patients with colorectal cancer. We performed a retrospective analysis of 310 consecutive patients diagnosed at our institution between 2004 and 2013. The patients (48.7% male and 51.3% female) had a mean age of 69.9 years (+/- 12.7 years) at diagnosis. Thrombocytosis was found in a total of 25 patients, with a higher incidence in those with stage III and IV disease (14.4% of patients). Although the mean platelet count increased with the depth of tumor invasion (pT), its values remained within normal limits in the whole patient cohort. No patient with stage I cancer (n=57) had elevated platelet count at diagnosis. By contrast, five of the 78 patients (6.4%) with stage II cancer showed thrombocytosis, and four of these patients showed early recurrence and/or metastatic disease, resulting in shortened survival (they died within one year after surgery). The incidence of thrombocytosis increased to 12.2% and 20.6%, respectively, in patients with stage III and IV disease. The overall survival rate of patients with thrombocytosis was lower than those without thrombocytosis in the stage II and III disease groups, but this difference disappeared in patients with stage IV cancer who did poorly regardless of their platelet count. We concluded that thrombocytosis at diagnosis indicates adverse clinical outcome in colorectal cancer patients with stage II or III disease. This observation is especially intriguing in stage II patients because the clinical management of these patients is controversial. If our data are confirmed in larger studies, stage II colon cancer patients with thrombocytosis should be upstaged and treated as stage III/IV disease patients.

Prognostic significance of initial platelet counts and fibrinogen level in advanced non-small cell lung cancer.

Thrombocytosis and coagulation systems activation are commonly associated with disease progression and are suggested poor prognostic factors in patients with malignancies. This study aimed to investigate the prevalence and prognostic significance of thrombocytosis and elevated fibrinogen levels in patients with advanced non-small cell lung cancer (NSCLC). Initial platelet counts and fibrinogen levels were reviewed in 854 patients with histologically proven NSCLC. Thrombocytosis was defined as platelet counts > 450 × 10(9)/L. A serum fibrinogen level > 4.5 g/L was considered high. At the time of diagnosis, initial platelet counts and serum fibrinogen levels were evaluated before treatment. Clinicopathologic data including histological type, tumor, node, metastasis (TNM) stage, performance status, treatment method, and survival time were evaluated. Initial thrombocytosis was found in 6.9% of patients, and elevated fibrinogen levels were found in 55.1% of patients. Patients with thrombocytosis had a significantly poorer prognosis than patients with normal platelet counts (P < 0.001). In multivariate survival analysis, thrombocytosis was an independent prognostic factor (P < 0.001). An elevated serum fibrinogen level was associated with poor prognosis (P < 0.001). In conclusion, initial thrombocytosis and a high fibrinogen level are independent factors for predicting poor prognosis in patients with advanced NSCLC.

Prognostic significance of thrombocytosis, platelet parameters and aggregation rates in epithelial ovarian cancer

The aim of this study is to investigate the impact of preoperative platelet counts, parameters and aggregation rates (maximal aggregation rate: MAR) on prognosis in patients with epithelial ovarian cancer (EOC). Preoperative platelet count, parameters and MAR in 182 EOC patients, 122 patients with benign ovarian tumor and 150 healthy women were retrospectively analyzed. The correlation between thrombocytosis, platelet parameters, MAR and clinicopathological factors were evaluated in EOC. Forty-five (24.73%) EOC patients had preoperative thrombocytosis in this study. The mean platelet count in the EOC group was significantly higher than that of benign and healthy groups (P < 0.001). The MAR in the EOC group was significantly higher than that in the healthy group (71.96% vs 57.03%, P = 0.025). The platelet parameters (mean platelet volume, platelet distribution width, thrombocytocrit and large platelet ratio) were consistently higher in the EOC group than those in the benign and healthy groups, but the differences were insignificant. A significant correlation between thrombocytosis and MAR was observed in EOC patients (r = 0.694, P < 0.001). EOC patients with thrombocytosis were found to have significantly higher grade (P = 0.048), more advanced stage (P = 0.045), higher level carbohydrate antigen-125 (P = 0.007) and greater likelihood of suboptimal cytoreduction (P = 0.035). EOC patients with both thrombocytosis and high MAR were found to have shorter progression-free survival (P = 0.001)and overall survival (P = 0.004). The combination of thrombocytosis and MAR, as well as stage and optimal cytoreduction, retained significance as an independent prognostic factor for overall survival. Thrombocytosis, accompanied by increasing of platelet aggregation rates, is associated with more aggressive tumor biology in EOC. The combination of thrombocytosis and MAR is an independent negative prognostic factor for overall survival in EOC patients.

Increased platelet count is an indicator of metastasis in patients with nasopharyngeal carcinoma

This study aims to evaluate the impact of pretreatment thrombocytosis on survival in patients with nasopharyngeal carcinoma (NPC). The data of 1,582 patients with NPC, who underwent definitive treatment between 2003 and 2004, were retrospectively reviewed. The correlation between the clinicopathological variables and the platelet count was analyzed. The prognostic significance of thrombocytosis, together with various clinicopathological factors, was evaluated by univariate and multivariate analyses. Platelet count showed significant correlation with gender, clinical stage, and T stage in univariate analysis. There was poorer 5-year disease-specific survival (DSS) in the patients with thrombocytosis than in those without thrombocytosis (70 vs. 78%; p = 0.001) and poorer metastases-free survival (MFS) (81 vs. 88%; p = 0.006). Univariate and multivariate analyses showed that thrombocytosis was an independent prognostic factor for MFS and DSS. Thrombocytosis is a useful predictor of metastasis and poor prognosis in patients with NPC.

Thrombocytosis in Myelodysplastic Syndromes: Not an Innocent Bystander

Background: Myelodysplastic Syndromes (MDS) are typically characterized by peripheral blood cytopenias. However, some MDS is associated with thrombocytosis rather than thrombocytopenia. The prognostic significance of thrombocytosis is unknown. The purpose of this study is to determine if thrombocytosis predicts Overall Survival (OS). Methods: We reviewed a prospective cohort of patients with myeloid disorders from 1994 to July 2011. The median duration of observation was 6.3 years. The cohort included 5,886 bone marrow biopsies or aspirates from 2,042 patients. OS of patients with thrombocytosis was compared to WHO case matched patients with normal (100-450,000) and low platelet counts (<100,000). All-cause mortality was evaluated using Cox proportional hazard regression modeling and Kaplan Meier methods. Results: Thrombocytosis occurred in 5% (102/2,042) of patients throughout their disease. Platelet counts remained stable in 86% of patients (1,593/1,856) and thrombocytosis was constant in 93% of patients (86/92). Patients with thrombocytosis had significantly decreased OS compared to those with normal platelet counts in multivariate analysis adjusted for age and IPSS score (P< 0.035). Patients with normal platelet counts had the best prognosis and patients whose platelet counts changed during their disease course had the worst survival (p< 0.0009). Conclusions: MDS patients with thrombocytosis have significantly decreased OS compared to those with normal platelet counts. The IPSS score does not accurately predict their prognosis.

The Clinical and Biologic Significance of Thrombocytosis in Myeloid Disorders

Abstract 5031 PurposeMyelodysplastic syndromes (MDS) are typically characterized by peripheral blood cytopenias. However, some MDS is associated with thrombocytosis rather than thrombocytopenia. The prognostic significance of thrombocytosis is unknown. The purpose of this study was to compare the overall survival (OS) of MDS patient based on their platelet count. MethodsWe reviewed a prospective cohort of patients with myeloid disorders from 1994 to present. Out of the 1,654 unique patients, 102 had platelets > 450,000 (5.7%) throughout their disease; 88 had stable platelet counts, 6 had varying platelet counts, and 12 were excluded because of missing information.OS of patients with thrombocytosis (>450,000 platelet count) was compared to FAB/WHO case matched patients with normal (100–450 platelet counts) and low platelet counts (<100 platelet count). OS was evaluated using unadjusted and adjusted Cox proportional hazard regression modeling with all-cause mortality as the dependent variable and demographic and clinical characteristics as independent variable; adjusted for IPSS risk group at first sample collection and age-adjusted mortality. The OS curves were constructed using Kaplan-Meier methods. ResultsThe worst OS occurred in patients with unstable platelet counts, followed by thrombocytopenia, and then thrombocytosis. Thrombocytopenia was associated with a poorer prognosis than thrombocytosis, although not significantly worse. Patients with normal platelet counts had the best prognosis. Thrombocytosis significantly reduced OS compared to patients with normal platelet counts (HR 1.44, p= 0.04) using adjusted Cox analysis. Thrombocytopenia had significantly reduced OS compared to patient with normal platelet counts (HR 1.8, p=0.0002) using unadjusted Cox regression. Patients who had unstable platelet counts had significantly the worst OS (HR 5.7, p= 0.0009). Both older age at diagnosis and IPSS independently and significantly affected OS. ConclusionMDS patients with both thrombocytopenia and thrombocytosis have significantly decreased OS compared to normal platelet counts.{abspict} [Display omitted] Disclosures:No relevant conflicts of interest to declare.

The impact of pretreatment thrombocytosis and persistent thrombocytosis after adjuvant chemotherapy in patients with advanced epithelial ovarian cancer

Objective To evaluate the impact of both pretreatment thrombocytosis, and platelet count reduction post-adjuvant chemotherapy, on survival in patients with advanced epithelial ovarian cancer. Methods Records of 179 women who underwent cytoreductive surgery for FIGO stage III or IV epithelial ovarian cancer and received six cycles of platinum/paclitaxel-based chemotherapy between July1998 and March 2009 were retrospectively reviewed. Platelet ratio was defined as the preoperative platelet count divided by the platelet count after chemotherapy. The prognostic significance of thrombocytosis and platelet ratio, together with various clinicopathological factors, were evaluated by multivariate analysis. Results Sixty-two of 179 (34.6%) patients had thrombocytosis at primary diagnosis. Patients with preoperative thrombocytosis had greater elevations of CA-125 ( p < 0.0001) and a greater volume of ascites ( p = 0.007). On multivariate analysis, thrombocytosis and CA-125 elevation retained significance as indicators of poor prognosis in patients with stage III or IV disease. In patients with normal CA-125 after chemotherapy, a high platelet ratio was an independent risk factor for reduced survival ( p = 0.05). Conclusions Preoperative thrombocytosis and a high platelet ratio appear to be poor prognostic factors of survival in patients with advanced epithelial ovarian cancer who were treated with cytoreductive surgery and adjuvant platinum/paclitaxel-based chemotherapy.

The prognostic significance of thrombocytosis in uterine papillary serous carcinomas

We have shown that preoperative thrombocytosis (platelet counts >400 x 10(9)/l) is an independent poor prognostic factor in epithelial ovarian cancers (EOC) and is associated with worse survival. In light of the similarities between uterine papillary serous carcinomas (UPSC) and EOC, we sought to determine the incidence of thrombocytosis in UPSC and examine associations with clinico-pathologic features and survival. 68 patients with UPSC were identified between 1996 and 2004 at 3 institutions. After IRB approval, records were retrospectively reviewed and data analyzed using Chi-squared and Cox proportional hazards model; survival was analyzed by the method of Kaplan and Meier. 8/68 (12%) patients had thrombocytosis at primary diagnosis. Patients with thrombocytosis were found to have more advanced stage disease (p=0.002) and ascites >1 L (p<0.0001). Of the 21 patients with stage IV disease, those with normal preoperative platelet counts demonstrated a greater likelihood of optimal tumor resection to less than 1 cm residual disease (13/15 versus 1/6 in patients with thrombocytosis, p<0.002). Patients with thrombocytosis had a shorter disease-free interval (17 months versus median survival not yet reached, p=0.0067) and overall survival (24 versus 45 months, p=0.0026). On multivariate analysis, thrombocytosis retained significance as a poor prognostic indicator in patients after controlling for age and stage (p=0.04). Thrombocytosis may be a marker of aggressive tumor biology in UPSC. Platelet-secreted growth factors may promote aggressive cancer phenotype through contribution to metastasis, invasion, and primary tumor growth.

Prognostic Significance of Thrombocytosis in Node-negative Colon Cancer

Several clinical studies have shown that thrombocytosis is a poor prognostic factor in some types of cancer, but data about the impact of thrombocytosis on prognosis in patients with colon cancer are very limited. We investigated the prevalence and prognostic effect of pre-operative thrombocytosis, defined as a platelet count > 400 x 10(9)/l, retrospectively in patients with node-negative colon cancer. Out of 198 patients, 24 (12.1%) had thrombocytosis, and its presence correlated with tumour depth and lymphatic invasion. Univariate analysis revealed that disease-free survival and overall survival were shorter in patients with pre-operative thrombocytosis than those without thrombocytosis. On multivariate analysis, thrombocytosis alone retained significance as a poor prognostic factor for both disease-free survival and overall survival. In conclusion, this study shows an association between thrombocytosis and poor survival in patients with node-negative colon cancer. The preoperative platelet count may help to identify patients with an unfavourable prognosis in this subgroup.

Prognostic significance of thrombocytosis in renal cell carcinoma patients.

Thrombocytosis has been reported in many types of malignancies and has been studied as a prognostic factor. In the present study, we examined the incidence of thrombocytosis in patients with renal cell carcinoma (RCC) in order to evaluate the prognostic value of thrombocytosis. One hundred and ninety-six patients treated by radical nephrectomy for RCC were enrolled in this study. We divided the patients into a normal platelet count group and a thrombocytosis group according to the presurgical platelet count. The two groups were compared pathologically and clinically, including prognosis. Thrombocytosis was present in 16 patients (8.2%). Platelet counts had normalized after nephrectomy in all patients with thrombocytosis. There was no correlation between histological type or grade and thrombocytosis. However, there were correlations between thrombocytosis and tumor size and tumor stage. Patients with thrombocytosis had a worse prognosis than patients without thrombocytosis (P = 0.0028). When adjusted for stage or tumor size, the correlation was limited to low stage (stage 1 + 2: P = 0.0041, stage 3 + 4: P = 0.2983) or small tumors (tumor size: </=4 cm, P = 0.0021; 4-7 cm, P = 0.0142; >7 cm, P = 0.8158). Thrombocytosis is an inexpensive and easy tool with which to evaluate the prognosis of RCC patients in daily medical practice.

752: Prognostic Significance of Thrombocytosis in Renal Cell Carcinoma

752: Prognostic Significance of Thrombocytosis in Renal Cell Carcinoma

714 Prognostic significance of thrombocytosis in renal cell carcinoma

714 Prognostic significance of thrombocytosis in renal cell carcinoma

The prognostic significance of thrombocytosis in epithelial ovarian carcinoma

Objective. The objective of this study was to determine the incidence of thrombocytosis in epithelial ovarian carcinoma and examine associations with clinico-pathologic features. Thrombocytosis (platelet counts >400 × 10 9/l) has been identified as a poor prognostic factor in many cancers. Platelet-secreted factors may contribute to metastasis, invasion, and primary tumor growth. Methods. One hundred eighty-three patients with invasive epithelial ovarian or primary peritoneal carcinomas were identified between January 1996 and December 2000. Records were retrospectively reviewed and data analyzed using χ 2, Student's t test, and Cox proportional hazards model; survival was analyzed by the method of Kaplan and Meier. Results. Forty-one of 183 (22.4%) patients had thrombocytosis at primary diagnosis. Patients with preoperative thrombocytosis were found to have greater elevations of CA-125 ( P = 0.026), more advanced stage disease ( P = 0.016), higher grade tumors ( P = 0.010), more frequent lymph node metastases ( P = 0.018), and greater volume of ascites ( P < 0.0001). One hundred sixty of 183 (87.4%) patients achieved optimal cytoreduction; patients with thrombocytosis demonstrated a greater likelihood of suboptimal resection (residual disease >1 cm; 19/41 vs. 4/142 in patients without thrombocytosis, P < 0.0001). Patients with thrombocytosis had a shorter disease-free interval (12 vs. 34 months, P < 0.0001) and overall survival (28 vs. 79 months, P < 0.0001). On multivariate analysis, thrombocytosis retained significance as a poor prognostic indicator in patients with stage III and IVA disease ( P = 0.04). Conclusions. Thrombocytosis is a frequent preoperative finding in ovarian and peritoneal carcinomas and may be a marker of aggressive tumor biology.

Prognostic implications of thrombocytosis in patients with stage III and IV cervical cancer

Gucer F, Tamussino K, Panzitt T, Taucher A, Haas J, Petru E, Winter R. Prognostic implications of thrombocytosis in patients with stage III and IV cervical cancer. Int J Gynecol Cancer 1998; 8: 369–373. The purpose of this study was to evaluate the prognostic significance of thrombocytosis in patients with advanced (stage III and IV) cervical cancer. A total of 128 patients without conditions associated with thrombocytosis who received a diagnosis of stage III or IV cervical carcinoma at our department between 1985 and 1993 were included in the study. Thrombocytosis was defined as a platelet count above 400,000/μl. Ninety-two of 128 patients (72 %) had stage III and 36 (28%) had stage IV disease. Squamous cell carcinomas accounted for 109 (85%) of the carcinomas. Median follow-up was 11 months (range 1–106 months). Thrombocytosis was present in 33 of 128 (26%) patients. The mean pretreatment platelet count ± standard deviation ( SD) was 345,000 ± 135,000. The estimated overall five-year survival rate was 16%. The five-year survival rate of the 33 patients with thrombocytosis was significantly worse than that of the 95 patients with a platelet count 0.05). In multivariate analysis, age, hemoglobin, and treatment (vs palliation) were significantly associated with prognosis, whereas thrombocytosis was not. Thrombocytosis is not an independent prognostic factor in advanced stage cervical cancer.

Significance of thrombocytosis in patients with epithelial ovarian cancer

Abstract OBJECTIVES: Our objective was to determine the relevance of a preoperative platelet count in ovarian cancer. Special interest was directed to a possible prognostic significance of thrombocytosis in this disease. STUDY DESIGN: Charts of 130 patients with epithelial ovarian cancer were reviewed retrospectively. Survival analyses were performed with the Kaplan-Meier method. Differences in survival were examined according to Mantel and Breslow. Platelet counts were furthermore correlated to other clinical parameters. For this purpose the Spearman rank test and a stepwise logistic regression model were used. Data comparison was accomplished with the Mann-Whitney U test and the χ 2 test. RESULTS: Prevalence of thrombocytosis was 38%. No differences in survival between patients with or without thrombocytosis was found. Volume of ascities and hemoglobin concentrations were independently associated with thrombocytosis ( p = 0.002 and p=0.004, respectively). CONCLUSIONS: Thrombocytosis is not a useful prognostic factor in ovarian cancer. Elevated platelets are predominately associated with the presence of ascites and marked anemia. (AM J OBSTET GYNECOL 1994;170:549-54.)