Ann Surg Treat Res.  2016 Jun;90(6):322-327. 10.4174/astr.2016.90.6.322.

Preoperative thrombocytosis predicts prognosis in stage II colorectal cancer patients

• Lee YS
• Suh KW
• Oh SY

• KMID: 2164793
• DOI: http://doi.org/10.4174/astr.2016.90.6.322

Abstract

PURPOSE
Thrombocytosis is known to be a poor prognostic factor in several types of solid tumors. The prognostic role of preoperative thrombocytosis in colorectal cancer remains limited. The aim of this study is to investigate the prognostic role of preoperative thrombocytosis in stage II colorectal cancer.
METHODS
Two hundred eighty-four patients with stage II colorectal cancer who underwent surgical resection between December 2003 and December 2009 were retrospectively reviewed. Thrombocytosis was defined as platelet > 450 × 10(9)/L. We compared patients with thrombocytosis and those without thrombocytosis in terms of survival.
RESULTS
The 5-year disease-free survival (DFS) rates were lower in patients with thrombocytosis compared to those without thrombocytosis in stage II colorectal cancer (73.3% vs. 89.6%, P = 0.021). Cox multivariate analysis demonstrated that thrombocytosis (hazard ratio, 2.945; 95% confidence interval, 1.127-7.697; P = 0.028) was independently associated with DFS in patients with stage II colorectal cancer.
CONCLUSION
This study showed that thrombocytosis is a prognostic factor predicting DFS in stage II colorectal cancer patients.

Keyword

Thrombocytosis; Prognosis; Colorectal neoplasms

MeSH Terms

Blood Platelets
Colorectal Neoplasms*
Disease-Free Survival
Humans
Multivariate Analysis
Prognosis*
Retrospective Studies
Thrombocytosis*

Figure

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  Fig. 1 Comparison of 5-year disease-free survival rate between patients with thrombocytosis and those without thrombocytosis.

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  Fig. 2 Comparison of 5-year cancer-specific survival rate between patients with thrombocytosis and those without thrombocytosis.

Reference

1. O'Connell MJ, Mailliard JA, Kahn MJ, Macdonald JS, Haller DG, Mayer RJ, et al. Controlled trial of fluorouracil and low-dose leucovorin given for 6 months as postoperative adjuvant therapy for colon cancer. J Clin Oncol. 1997; 15:246–250.

2. Zaniboni A, Labianca R. Gruppo Italiano per lo Studio e la Cura dei Tumori del Digerente. Adjuvant therapy for stage II colon cancer: an elephant in the living room? Ann Oncol. 2004; 15:1310–1318.

3. Griffin MR, Bergstralh EJ, Coffey RJ, Beart RW Jr, Melton LJ 3rd. Predictors of survival after curative resection of carcinoma of the colon and rectum. Cancer. 1987; 60:2318–2324.

4. Wiggers T, Arends JW, Volovics A. Regression analysis of prognostic factors in colorectal cancer after curative resections. Dis Colon Rectum. 1988; 31:33–41.

5. Minsky BD, Mies C, Rich TA, Recht A. Lymphatic vessel invasion is an independent prognostic factor for survival in colorectal cancer. Int J Radiat Oncol Biol Phys. 1989; 17:311–318.

6. Betge J, Pollheimer MJ, Lindtner RA, Kornprat P, Schlemmer A, Rehak P, et al. Intramural and extramural vascular invasion in colorectal cancer: prognostic significance and quality of pathology reporting. Cancer. 2012; 118:628–638.

7. Maraz A, Furak J, Varga Z, Kahan Z, Tiszlavicz L, Hideghety K. Thrombocytosis has a negative prognostic value in lung cancer. Anticancer Res. 2013; 33:1725–1729.

8. Shimada H, Oohira G, Okazumi S, Matsubara H, Nabeya Y, Hayashi H, et al. Thrombocytosis associated with poor prognosis in patients with esophageal carcinoma. J Am Coll Surg. 2004; 198:737–741.

9. Men H, Liang C, Yu M. Thrombocytosis as a prognostic factor in patients with renal cell carcinoma: a meta-analysis of literature. J Cancer Res Ther. 2015; 11:67–72.

10. Lerner DL, Walsh CS, Cass I, Karlan BY, Li AJ. The prognostic significance of thrombocytosis in uterine papillary serous carcinomas. Gynecol Oncol. 2007; 104:91–94.

11. Stone RL, Nick AM, McNeish IA, Balkwill F, Han HD, Bottsford-Miller J, et al. Paraneoplastic thrombocytosis in ovarian cancer. N Engl J Med. 2012; 366:610–618.

12. Taucher S, Salat A, Gnant M, Kwasny W, Mlineritsch B, Menzel RC, et al. Impact of pretreatment thrombocytosis on survival in primary breast cancer. Thromb Haemost. 2003; 89:1098–1106.

13. Qiu MZ, Yuan ZY, Luo HY, Ruan DY, Wang ZQ, Wang FH, et al. Impact of pretreatment hematologic profile on survival of colorectal cancer patients. Tumour Biol. 2010; 31:255–260.

14. Ishizuka M, Nagata H, Takagi K, Iwasaki Y, Kubota K. Preoperative thrombocytosis is associated with survival after surgery for colorectal cancer. J Surg Oncol. 2012; 106:887–891.

15. Sasaki K, Kawai K, Tsuno NH, Sunami E, Kitayama J. Impact of preoperative thrombocytosis on the survival of patients with primary colorectal cancer. World J Surg. 2012; 36:192–200.

16. Scholz HS, Petru E, Gücer F, Haas J, Tamussino K, Winter R. Preoperative thrombocytosis is an independent prognostic factor in stage III and IV endometrial cancer. Anticancer Res. 2000; 20(5C):3983–3985.

17. Nyasavajjala SM, Runau F, Datta S, Annette H, Shaw AG, Lund JN. Is there a role for pre-operative thrombocytosis in the management of colorectal cancer? Int J Surg. 2010; 8:436–438.

18. Kandemir EG, Mayadagli A, Karagoz B, Bilgi O, Turken O, Yaylaci M. Prognostic significance of thrombocytosis in node-negative colon cancer. J Int Med Res. 2005; 33:228–235.