DOI QR코드

DOI QR Code

Preoperative Thrombocytosis and Poor Prognostic Factors in Endometrial Cancer

  • Heng, Suttichai (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) ;
  • Benjapibal, Mongkol (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University)
  • Published : 2015.01.06

Abstract

This study aimed to evaluate the prevalence of preoperative thrombocytosis and its prognostic significance in Thai patients with endometrial cancer. We retrospectively reviewed the medical records of 238 cases who had undergone surgical staging procedures between January 2005 and December 2008. Associations between clinicopathological variables and preoperative platelet counts were analyzed using Pearson's chi square or two-tailed Fisher's exact tests. Survival analysis was performed with Kaplan-Meier estimates. Univariate and Cox-regression models were used to evaluate the prognostic impact of various factors including platelet count in terms of disease-free survival and overall survival. The mean preoperative platelet count was $315,437/{\mu}L$ (SD $100,167/{\mu}L$). Patients who had advanced stage, adnexal involvement, lymph node metastasis, and positive peritoneal cytology had significantly higher mean preoperative platelet counts when compared with those who had not. We found thrombocytosis (platelet count greater than $400,000/{\mu}L$) in 18.1% of our patients with endometrial cancer. These had significant higher rates of advanced stage, cervical involvement, adnexal involvement, positive peritoneal cytology, and lymph node involvement than patients with a normal pretreatment platelet count. The 5-year disease-free survival and overall survival were significantly lower in patients who had thrombocytosis compared with those who had not (67.4% vs. 85.1%, p=0.001 and 86.0% vs. 94.9%, p=0.034, respectively). Thrombocytosis was shown to be a prognostic factor in the univariate but not the multivariate analysis. In conclusion, presence of thrombocytosis is not uncommon in endometrial cancer and may reflect unfavorable prognostic factors but its prognostic impact on survival needs to be clarified in further studies.

Keywords

Platelet count;thrombocytosis;prognostic factors;endometrial cancer

References

  1. Ayhan A, Bozdaf G, TaokAran C, et al (2006). The value of preoperative platelet count in the prediction of cervical involvement and poor prognostic variables in patients with endometrial carcinoma. Gynecol Oncol, 103, 902-5. https://doi.org/10.1016/j.ygyno.2006.05.034
  2. Costantini V, Zacharski LR, Moritz TE, Edwards RL (1990). The platelet count in carcinoma of the lung and colon. Thromb Haemost, 64, 501-5.
  3. Erdemir F, Kilciler M, Bedir S, et al (2007). Clinical significance of platelet count in patients with renal cell carcinoma. Urol Int, 79, 111-6. https://doi.org/10.1159/000106322
  4. Ferlay J, Shin HR, Bray F, et al (2010). Cancer incidence and mortality worldwide; in GLOBOCAN 2008, version 1.2. IARC CancerBase No.10. Lyon, France, IARC. Availble from: http://www.dep.iarc.fr/globocan/globocan.htm.
  5. Gorelick C, Andikyan V, Mack M, Lee YC, Abulafia O (2009). Prognostic significance of preoperative thrombocytosis in patients with endometrial carcinoma in an inner-city population. Int J Gynecol Cancer, 19, 1384-9. https://doi.org/10.1111/IGC.0b013e3181a47d47
  6. Gucer F, Moser F, Tamussino K, et al (1998). Thrombocytosis as a prognostic factor in endometrial carcinoma. Gynecol Oncol, 70, 210-4. https://doi.org/10.1006/gyno.1998.5078
  7. Hefler L, Mayerhofer K, Leibman B, et al (2000). Tumor anemia and thrombocytosis in patients with vulvar cancer. Tumour Biol, 21, 309-14. https://doi.org/10.1159/000030136
  8. Hernandez E, Donohue KA, Anderson LL, Heller PB, Stehman FB (2000). The significance of thrombocytosis in patients with locally advanced cervical carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol, 78, 137-42. https://doi.org/10.1006/gyno.2000.5838
  9. Hernandez E, Lavine M, Dunton CJ, Gracely E, Parker J (1992). Poor prognosis associated with thrombocytosis in patients with cervical cancer. Cancer, 69, 2975-7. https://doi.org/10.1002/1097-0142(19920615)69:12<2975::AID-CNCR2820691218>3.0.CO;2-A
  10. Ikeda M, Furukawa H, Imamura H, et al (2002). Poor prognosis associated with thrombocytosis in patients with gastric cancer. Ann Surg Oncol, 9, 287-91. https://doi.org/10.1007/BF02573067
  11. Kabir S, Darr GA (1995). Serum levels of interleukine-1, interleukine-6 and tumour necrosis factor-alpha in patients with gastric carcinoma. Cancer Lett, 95, 207-12. https://doi.org/10.1016/0304-3835(95)03895-4
  12. Li AJ, Madden AC, Cass I, et al (2004). The prognostic significance of thrombocytosis in epithelial ovarian carcinoma. Gynecol Oncol, 92, 211-4. https://doi.org/10.1016/j.ygyno.2003.09.002
  13. Lidor YJ, Xu FJ, Martinez-Maza O, et al (1993). Constitutive production of macrophage colony-stimulating factor and interleukine-6 by human ovarian surface epithelial cells. Exp Cell Res, 20, 332-9.
  14. Menczer J, Geva D, Schejter E, Zakut H (1996). Elevated platelet count in patients with endometrial carcinoma: correlation with selected prognostic factors and with survival. Int J Gynecol Cancer, 6, 463-6. https://doi.org/10.1046/j.1525-1438.1996.06060463.x
  15. Metindir J, Dilek GB (2009). Preoperatiove hemoglobin and platelet count and poor prognostic factors in patients with endometrial carcinoma. J Cancer Res Clin Oncol, 135, 125-9. https://doi.org/10.1007/s00432-008-0430-2
  16. 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, 916-8.
  17. Nakazaki H (1992). Preoperative and postoperative cytokines in patients with cancer. Cancer, 70, 709-13. https://doi.org/10.1002/1097-0142(19920801)70:3<709::AID-CNCR2820700328>3.0.CO;2-O
  18. O'Keefe SC, Marshall FF, Issa MM, Harmon MP, Petros JA (2002). Thrombocytosis is associated with a significant increase in the cancer specific death rate after radical nephrectomy. J Urol, 168, 1378-80. https://doi.org/10.1016/S0022-5347(05)64453-9
  19. Pedersen LM, Milman N (1996). Prognostic significance of thrombocytosis in patients with primary lung cancer. Eur Respir J, 9, 1826-30. https://doi.org/10.1183/09031936.96.09091826
  20. Pieter HR, Henri HV, Saskia M (2012). Mechanistic view of risk factors for venous thromboembolism. Arterioscler Thromb Vasc Biol, 32, 563-8. https://doi.org/10.1161/ATVBAHA.111.242818
  21. Riess L (1872). Zur pathologischen Anatomie des Blutes. Arch Anat Physiol Wissensch Med, 39, 237-49.
  22. 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, 3983-5.
  23. Shimada H, Oohira G, Okazumi S, et al (2004). Thrombocytosis associated with poor prognosis in patients with esophageal carcinoma. J Am Coll Surg, 198, 737-41. https://doi.org/10.1016/j.jamcollsurg.2004.01.022
  24. Sierko E, Wojtukiewicz MZ (2004). Platelets and angiogenesis in malignancy. Semin Thromb Hemost, 30, 95-108. https://doi.org/10.1055/s-2004-822974
  25. Tamussino KF, Gucer F, Reich O, et al (2001). Pretreatment hemoglobin, platelet count and prognosis in endometrial carcinoma. Int J Gynecol Cancer, 11, 236-40. https://doi.org/10.1046/j.1525-1438.2001.01024.x
  26. Taucher S, Salat A, Gnant M, et al (2003). Impact of pretreatment thrombocytosis on survival in primary breast cancer. Thromb Haemost, 89, 1098-106.
  27. Wu CW, Wang SR, Chao MF, et al (1996). Serum interleukine-6 levels reflect disease status of gastric cancer. Am J Gastroenterol, 91, 1417-22.
  28. Zeimet AG, Marth C, Muller-Holzner E, Daxenbichler G, Dapunt O (1994). Significance of thrombocytosis in patients with epithelial ovarian cancer. Am J ObstetGynecol, 170, 549-54. https://doi.org/10.1016/S0002-9378(94)70225-X

Cited by

  1. Association of decreased mean platelet volume with renal cell carcinoma vol.22, pp.6, 2017, https://doi.org/10.1007/s10147-017-1158-2
  2. The Significance of Pretreatment Thrombocytosis and Its Association With Neutrophilia in Patients With Surgically Treated Endometrial Cancer vol.27, pp.7, 2017, https://doi.org/10.1097/IGC.0000000000001019
  3. Preoperative elevated platelet count and thrombocytosis in gynecologic malignancies vol.295, pp.1, 2017, https://doi.org/10.1007/s00404-016-4212-9
  4. Preoperative thrombocytosis as a prognostic factor in endometrioid-type endometrial carcinoma vol.37, pp.5, 2017, https://doi.org/10.5144/0256-4947.2017.393
  5. Platelet distribution width correlates with prognosis of non-small cell lung cancer vol.7, pp.1, 2017, https://doi.org/10.1038/s41598-017-03772-z
  6. Clinical significance of coagulation factors in operable colorectal cancer vol.13, pp.6, 2017, https://doi.org/10.3892/ol.2017.6058
  7. Pretreatment thrombocytosis predict poor prognosis in patients with endometrial carcinoma: a systematic review and meta-analysis vol.19, pp.1, 2019, https://doi.org/10.1186/s12885-018-5264-y