Prognostic value of thrombocytosis in patients undergoing surgery for colorectal cancer with synchronous liver metastases
- 57 Downloads
The purpose of this study was to evaluate the prognostic role of thrombocytosis in patients with synchronous colorectal liver metastases (CRLM).
Retrospective analysis of patients who underwent surgery for colorectal cancer with synchronous CRLM at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust between 2005 and 2016.
One hundred and ninety-six patients met the inclusion criteria. High platelet count (H-PC) was found in 32%, and it was associated with a higher rate of palliative surgery (p < 0.001), extra-hepatic metastases (p < 0.001), bilobar liver disease (p = 0.007), presence of more than three metastases (p = 0.005), biggest metastasis larger than 5 cm (p < 0.001), and CEA level higher than 200 ng/mL (p = 0.035). H-PC was significantly associated with poorer 5-year overall survival (14.3% vs. 34.3%; p = 0.001). At the multivariate analysis on R0-1 cases, platelet count resulted the only independent predictor of survival (HR 2.07, p = 0.036).
H-PC correlates with the main negative clinical–pathological factors in patients with synchronous CRLM, as well as with overall survival. Moreover, it was the only independent prognostic factor in those who underwent curative surgery.
KeywordsColorectal cancer Liver metastasis Thrombocytosis Platelet count Prognosis
Colorectal liver metastasis
Low platelet count
High platelet count
Positive predictive value
Negative predictive value
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The latest revision of the Helsinki Declaration and the Oviedo Declaration are the basis for the ethical conduct of the study. Ethical approval was obtained by the ethics committee of the University of Verona Hospital Trust with the reference number “42763 (CRINF-1034 CESC)”.
Achievement of informed consent from all patients was required to enter the study.
- 3.Sandström P, Røsok BI, Sparrelid E, Larsen PN, Larsson AL, Lindell G, et al. ALPPS improves resectability compared with conventional two-stage hepatectomy in patients with advanced colorectal liver metastasis. Ann Surg. 2017;267:1.Google Scholar
- 6.Akgül Ö, Çetinkaya E, Ersöz Ş, Tez M. Role of surgery in colorectal cancer liver metastases. World J Gastroenterol 2014;20:6113–22.Google Scholar
- 8.Viganò L, Capussotti L, Lapointe R, Barroso E, Hubert C, Giuliante F, et al. Early recurrence after liver resection for colorectal metastases: risk factors, prognosis, and treatment. A LiverMetSurvey-based study of 6025 patients. Ann Surg Oncol. 2014;21:1276–86. https://doi.org/10.1245/s10434-013-3421-8.CrossRefGoogle Scholar
- 15.Edge SB, Byrd DR, Compton CC, Fritz AG, Green FL, Trotti A. AJCC cancer staging manual, 7th ed. 2010.Google Scholar
- 26.Pearlstein E, Ambrogio C, Karpatkin S. Effect of antiplatelet antibody on the development of pulmonary metastases following injection of CT26 colon adenocarcinoma, Lewis lung carcinoma, and B16 amelanotic melanoma tumor cells into mice. Cancer Res. 1984;44:3884–7.Google Scholar
- 31.Pedrazzani C, Mantovani G, Salvagno GL, Baldiotti E, Ruzzenente A, Iacono C, et al. Elevated fibrinogen plasma level is not an independent predictor of poor prognosis in a large cohort of Western patients undergoing surgery for colorectal cancer. World J Gastroenterol. 2016;22:9994–10001.CrossRefGoogle Scholar
- 39.Del Prete M, Giampieri R, Loupakis F, Prochilo T, Salvatore L, Faloppi L, et al. Prognostic clinical factors in pretreated colorectal cancer patients receiving regorafenib: implications for clinical management. Oncotarget. 2015;6:33982–92.Google Scholar