Journal of Gastrointestinal Cancer

, Volume 44, Issue 3, pp 293–304

Preoperative Platelet Count Associates with Survival and Distant Metastasis in Surgically Resected Colorectal Cancer Patients

  • Shaogui Wan
  • Yinzhi Lai
  • Ronald E. Myers
  • Bingshan Li
  • Terry Hyslop
  • Jack London
  • Devjani Chatterjee
  • Juan P. Palazzo
  • Ashlie L. Burkart
  • Kejin Zhang
  • Jinliang Xing
  • Hushan Yang
Original Research

DOI: 10.1007/s12029-013-9491-9

Cite this article as:
Wan, S., Lai, Y., Myers, R.E. et al. J Gastrointest Canc (2013) 44: 293. doi:10.1007/s12029-013-9491-9

Abstract

Objective

Platelets have been implicated in cancer metastasis and prognosis. No population-based study has been reported as to whether preoperative platelet count directly predicts metastatic recurrence of colorectal cancer (CRC) patients.

Design

Using a well-characterized cohort of 1,513 surgically resected CRC patients, we assessed the predictive roles of preoperative platelet count in overall survival, overall recurrence, as well as locoregional and distant metastatic recurrences.

Results

Patients with clinically high platelet count (≥400 × 109/L) measured within 1 month before surgery had a significantly unfavorable survival (hazard ratio [HR] = 1.66, 95 % confidence interval [CI] 1.34–2.05, P = 2.6 × 10−6, Plog rank = 1.1 × 10−11) and recurrence (HR = 1.90, 1.24–2.93, P = 0.003, Plog rank = 0.003). The association of platelet count with recurrence was evident only in patients with metastatic (HR = 2.81, 1.67–4.74, P = 1.1 × 10−4, Plog rank = 2.6 × 10−6) but not locoregional recurrence (HR = 0.59, 95 % CI 0.21–1.68, P = 0.325, Plog rank = 0.152). The findings were internally validated through bootstrap resampling (P < 0.01 at 98.6 % of resampling). Consistently, platelet count was significantly higher in deceased than living patients (P < 0.0001) and in patients with metastatic recurrence than locoregional (P = 0.004) or nonrecurrent patients (P < 0.0001). Time-dependent modeling indicated that the increased risks for death and metastasis associated with elevated preoperative platelet counts persisted up to 5 years after surgery.

Conclusion

Our data demonstrated that clinically high level of preoperative platelets was an independent predictor of CRC survival and metastasis. As an important component of the routinely tested complete blood count panel, platelet count may be a cost-effective and noninvasive marker for CRC prognosis and a potential intervention target to prevent metastatic recurrence.

Keywords

PlateletThrombocytosisCRCSurvivalRecurrenceMetastasis

Supplementary material

12029_2013_9491_MOESM1_ESM.docx (309 kb)
ESM 1(DOCX 309 kb)

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Shaogui Wan
    • 1
  • Yinzhi Lai
    • 1
  • Ronald E. Myers
    • 1
  • Bingshan Li
    • 2
  • Terry Hyslop
    • 3
  • Jack London
    • 4
  • Devjani Chatterjee
    • 4
  • Juan P. Palazzo
    • 5
  • Ashlie L. Burkart
    • 5
  • Kejin Zhang
    • 1
  • Jinliang Xing
    • 6
  • Hushan Yang
    • 1
  1. 1.Division of Population Science, Department of Medical Oncology, Kimmel Cancer CenterThomas Jefferson UniversityPhiladelphiaUSA
  2. 2.Center for Human Genetics Research, Department of Molecular Physiology and BiophysicsVanderbilt UniversityNashvilleUSA
  3. 3.Division of Biostatistics, Department of Pharmacology and Experimental TherapeuticsThomas Jefferson UniversityPhiladelphiaUSA
  4. 4.Department of Cancer BiologyThomas Jefferson UniversityPhiladelphiaUSA
  5. 5.Department of PathologyThomas Jefferson UniversityPhiladelphiaUSA
  6. 6.Department of Cell BiologyFourth Military Medical UniversityXi’anChina