Skip to main content
SpringerLink
Log in

Impact of Preoperative Thrombocytosis on the Survival of Patients with Primary Colorectal Cancer

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Although thrombocytosis has been reported in patients with various types of cancer, the association between thrombocytosis and the clinicopathological features of patients with colorectal cancer (CRC) has not been fully investigated. We evaluated the clinical features associated with thrombocytosis in CRC.

Materials and methods

The medical records of 636 consecutive CRC patients undergoing surgery in our department between January 2002 and July 2008 were retrospectively reviewed. The correlation between the clinicopathological variables and the preoperative platelet count was analyzed by univariate and multivariate analyses. The impact of thrombocytosis on the prognosis of these patients was assessed, in comparison with the other clinicopathological variables.

Results

Platelet count showed significant correlation with gender, age, venous involvement, tumor size, depth of invasion, regional lymph node metastasis, distant metastasis in univariate analysis, and tumor size and depth of invasion were independent factors in multivariate analysis. The cancer-specific survival (CSS) of CRC patients with thrombocytosis was significantly shorter than that for those without thrombocytosis (P < 0.001), specifically in patients with stage III CRC (P < 0.001). Multivariate analysis indicated that thrombocytosis was an independent prognostic factor of CSS (hazard ratio = 2.96, 95% confidence interval [CI] = 1.72–5.00). Moreover, within stage II CRC, the univariate analysis revealed that disease-free survival (DFS) was associated with preoperative thrombocytosis, but not the other clinicopathological variables.

Conclusions

Preoperative thrombocytosis is not only an independent indicator of poor CSS in CRC patients but also an independent predictor of poor DFS in patients with stage II CRC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Xu R, Zhou B, Fung PC et al (2006) Recent advances in the treatment of colon cancer. Histol Histopathol 21:867–872

    PubMed  CAS  Google Scholar 

  2. McArdle CS, Hole DJ (2002) Outcome following surgery for colorectal cancer: analysis by hospital after adjustment for case-mix and deprivation. Br J Cancer 86:331–335

    Article  PubMed  CAS  Google Scholar 

  3. O’Connell JB, Maggard MA, Ko CY (2004) Colon cancer survival rates with the new American Joint Committee on Cancer Sixth Edition staging. J Natl Cancer Inst 96:1420–1425

    Article  PubMed  Google Scholar 

  4. Graziano F, Cascinu S (2003) Prognostic molecular markers for planning adjuvant chemotherapy trials in Dukes B colorectal cancer patients: how much evidence is enough? Ann Oncol 14:1026–1038

    Article  PubMed  CAS  Google Scholar 

  5. McMillan DC, Crozier JE, Canna K et al (2007) Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancer. Int J Colorectal Dis 22:881–886

    Article  PubMed  Google Scholar 

  6. Jones JM, McGonigle NC, McAnespie M et al (2006) Plasma fibrinogen and serum C-reactive protein are associated with non-small cell lung cancer. Lung Cancer 53:97–101

    Article  PubMed  Google Scholar 

  7. Lee JH, Ryu KW, Kim S et al (2004) Preoperative plasma fibrinogen levels in gastric cancer patients correlate with extent of tumor. Hepatogastroenterology 51:1860–1863

    PubMed  Google Scholar 

  8. Oya M, Akiyama Y, Okuyama T et al (2001) High preoperative plasma D-dimer level is associated with advanced tumor stage and short survival after curative resection in patients with colorectal cancer. Jpn J Clin Oncol 31:388–394

    Article  PubMed  CAS  Google Scholar 

  9. Levitan N, Dowlati A, Remick SC et al (1999) Rates of initial and recurrent thromboembolic disease among patients with malignancy versus those without malignancy, Risk analysis using Medicare claims data. Medicine (Baltimore) 78:285–291

    Article  CAS  Google Scholar 

  10. Pedersen LM, Milman N (1996) Prognostic significance of thrombocytosis in patients with primary lung cancer. Eur Respir J 9:1826–1830

    Article  PubMed  CAS  Google Scholar 

  11. Scholz HS, Petru E, Gucer F et al (2000) Preoperative thrombocytosis is an independent prognostic factor in stage III and IV endometrial cancer. Anticancer Res 20:3983–3985

    PubMed  CAS  Google Scholar 

  12. Shimada H, Oohira G, Okazumi S et al (2004) Thrombocytosis associated with poor prognosis in patients with esophageal carcinoma. J Am Coll Surg 198:737–741

    Article  PubMed  Google Scholar 

  13. Monreal M, Fernandez-Llamazares J, Pinol M et al (1998) Platelet count and survival in patients with colorectal cancer—a preliminary study. Thromb Haemost 79:916–918

    PubMed  CAS  Google Scholar 

  14. Taucher S, Salat A, Gnant M et al (2003) Impact of pretreatment thrombocytosis on survival in primary breast cancer. Thromb Haemost 89:1098–1106

    PubMed  CAS  Google Scholar 

  15. Nyasavajjala SM, Runau F, Datta S et al (2010) Is there a role for preoperative thrombocytosis in the management of colorectal cancer? Int J Surg 8:436–438

    Article  PubMed  Google Scholar 

  16. Qiu MZ, Yuan ZY, Luo HY et al (2010) Impact of pretreatment hematologic profile on survival of colorectal cancer patients. Tumour Biol 31:255–260

    Article  PubMed  Google Scholar 

  17. Kandemir EG, Mayadagli A, Karagoz B et al (2005) Prognostic significance of thrombocytosis in node-negative colon cancer. J Int Med Res 33:228–235

    PubMed  CAS  Google Scholar 

  18. Amitrano L, Guardascione MA, Brancaccio V et al (2002) Coagulation disorders in liver disease. Semin Liver Dis 22:83–96

    Article  PubMed  CAS  Google Scholar 

  19. Klinger MH, Jelkmann W (2002) Role of blood platelets in infection and inflammation. J Interferon Cytokine Res 22:913–922

    Article  PubMed  CAS  Google Scholar 

  20. American Joint Cancer Commission (1997) AJCC cancer staging manual. In American Joint Committee on Cancer, 5th edn. Lippincott-Raven, Philadelphia

    Google Scholar 

  21. Erdemir F, Kilciler M, Bedir S et al (2007) Clinical significance of platelet count in patients with renal cell carcinoma. Urol Int 79:111–116

    Article  PubMed  Google Scholar 

  22. Ikeda M, Furukawa H, Imamura H et al (2002) Poor prognosis associated with thrombocytosis in patients with gastric cancer. Ann Surg Oncol 9:287–291

    Article  PubMed  Google Scholar 

  23. Ding PR, An X, Zhang RX et al (2010) Elevated preoperative neutrophil to lymphocyte ratio predicts risk of recurrence following curative resection for stage IIA colon cancer. Int J Colorectal Dis 25:1427–1433

    Article  PubMed  Google Scholar 

  24. Benson AB, Choti MA, Cohen AM et al (2000) NCCN practice guidelines for colorectal cancer. Oncology (Williston Park) 14:203–212

    Google Scholar 

  25. Benson AB, Schrag D, Somerfield MR et al (2004) American Society of Clinical Oncology recommendations on adjuvant chemotherapy for stage II colon cancer. J Clin Oncol 22:3408–3419

    Article  PubMed  Google Scholar 

  26. Blay JY, Favrot M, Rossi JF et al (1993) Role of interleukin-6 in paraneoplastic thrombocytosis. Blood 82:2261–2262

    PubMed  CAS  Google Scholar 

  27. Verheul HM, Pinedo HM (2003) The importance of platelet counts and their contents in cancer. Clin Cancer Res 9:3219–3221

    PubMed  CAS  Google Scholar 

  28. Verheul HM, Hoekman K, Lupu F et al (2000) Platelet and coagulation activation with vascular endothelial growth factor generation in soft tissue sarcomas. Clin Cancer Res 6:166–171

    PubMed  CAS  Google Scholar 

  29. Banks RE, Forbes MA, Kinsey SE et al (1998) Release of the angiogenic cytokine vascular endothelial growth factor (VEGF) from platelets: significance for VEGF measurements and cancer biology. Br J Cancer 77:956–964

    Article  PubMed  CAS  Google Scholar 

  30. Folman CC, Linthorst GE, van Mourik J et al (2000) Platelets release thrombopoietin (Tpo) upon activation: another regulatory loop in thrombocytopoiesis? Thromb Haemost 83:923–930

    PubMed  CAS  Google Scholar 

  31. Jain S, Harris J, Ware J (2010) Platelets: linking hemostasis and cancer. Arterioscler Thromb Vasc Biol 30:2362–2367

    Article  PubMed  CAS  Google Scholar 

  32. Janowska-Wieczorek A, Wysoczynski M, Kijowski J et al (2005) Microvesicles derived from activated platelets induce metastasis and angiogenesis in lung cancer. Int J Cancer 113:752–760

    Article  PubMed  CAS  Google Scholar 

  33. Nieswandt B, Hafner M, Echtenacher B et al (1999) Lysis of tumor cells by natural killer cells in mice is impeded by platelets. Cancer Res 59:1295–1300

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Kazuhito Sasaki, Kazushige Kawai, Nelson H. Tsuno, Eiji Sunami & Joji Kitayama

Authors
  1. Kazuhito Sasaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kazushige Kawai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nelson H. Tsuno
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eiji Sunami
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joji Kitayama
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kazuhito Sasaki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sasaki, K., Kawai, K., Tsuno, N.H. et al. Impact of Preoperative Thrombocytosis on the Survival of Patients with Primary Colorectal Cancer. World J Surg 36, 192–200 (2012). https://doi.org/10.1007/s00268-011-1329-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-011-1329-7

Keywords

Search

Navigation