Skip to main content
Top
Published in: World Journal of Surgery 1/2012

01-01-2012

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

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

Published in: World Journal of Surgery | Issue 1/2012

Login to get access

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.
Literature
1.
go back to reference Xu R, Zhou B, Fung PC et al (2006) Recent advances in the treatment of colon cancer. Histol Histopathol 21:867–872PubMed Xu R, Zhou B, Fung PC et al (2006) Recent advances in the treatment of colon cancer. Histol Histopathol 21:867–872PubMed
2.
go back to reference McArdle CS, Hole DJ (2002) Outcome following surgery for colorectal cancer: analysis by hospital after adjustment for case-mix and deprivation. Br J Cancer 86:331–335PubMedCrossRef McArdle CS, Hole DJ (2002) Outcome following surgery for colorectal cancer: analysis by hospital after adjustment for case-mix and deprivation. Br J Cancer 86:331–335PubMedCrossRef
3.
go back to reference 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 96:1420–1425PubMedCrossRef 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 96:1420–1425PubMedCrossRef
4.
go back to reference 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 14:1026–1038PubMedCrossRef 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 14:1026–1038PubMedCrossRef
5.
go back to reference 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 22:881–886PubMedCrossRef 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 22:881–886PubMedCrossRef
6.
go back to reference 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 53:97–101PubMedCrossRef 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 53:97–101PubMedCrossRef
7.
go back to reference Lee JH, Ryu KW, Kim S et al (2004) Preoperative plasma fibrinogen levels in gastric cancer patients correlate with extent of tumor. Hepatogastroenterology 51:1860–1863PubMed Lee JH, Ryu KW, Kim S et al (2004) Preoperative plasma fibrinogen levels in gastric cancer patients correlate with extent of tumor. Hepatogastroenterology 51:1860–1863PubMed
8.
go back to reference 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 31:388–394PubMedCrossRef 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 31:388–394PubMedCrossRef
9.
go back to reference 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) 78:285–291CrossRef 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) 78:285–291CrossRef
10.
go back to reference Pedersen LM, Milman N (1996) Prognostic significance of thrombocytosis in patients with primary lung cancer. Eur Respir J 9:1826–1830PubMedCrossRef Pedersen LM, Milman N (1996) Prognostic significance of thrombocytosis in patients with primary lung cancer. Eur Respir J 9:1826–1830PubMedCrossRef
11.
go back to reference 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 20:3983–3985PubMed 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 20:3983–3985PubMed
12.
go back to reference Shimada H, Oohira G, Okazumi S et al (2004) Thrombocytosis associated with poor prognosis in patients with esophageal carcinoma. J Am Coll Surg 198:737–741PubMedCrossRef Shimada H, Oohira G, Okazumi S et al (2004) Thrombocytosis associated with poor prognosis in patients with esophageal carcinoma. J Am Coll Surg 198:737–741PubMedCrossRef
13.
go back to reference Monreal M, Fernandez-Llamazares J, Pinol M et al (1998) Platelet count and survival in patients with colorectal cancer—a preliminary study. Thromb Haemost 79:916–918PubMed Monreal M, Fernandez-Llamazares J, Pinol M et al (1998) Platelet count and survival in patients with colorectal cancer—a preliminary study. Thromb Haemost 79:916–918PubMed
14.
go back to reference Taucher S, Salat A, Gnant M et al (2003) Impact of pretreatment thrombocytosis on survival in primary breast cancer. Thromb Haemost 89:1098–1106PubMed Taucher S, Salat A, Gnant M et al (2003) Impact of pretreatment thrombocytosis on survival in primary breast cancer. Thromb Haemost 89:1098–1106PubMed
15.
go back to reference 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 8:436–438PubMedCrossRef 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 8:436–438PubMedCrossRef
16.
go back to reference Qiu MZ, Yuan ZY, Luo HY et al (2010) Impact of pretreatment hematologic profile on survival of colorectal cancer patients. Tumour Biol 31:255–260PubMedCrossRef Qiu MZ, Yuan ZY, Luo HY et al (2010) Impact of pretreatment hematologic profile on survival of colorectal cancer patients. Tumour Biol 31:255–260PubMedCrossRef
17.
go back to reference Kandemir EG, Mayadagli A, Karagoz B et al (2005) Prognostic significance of thrombocytosis in node-negative colon cancer. J Int Med Res 33:228–235PubMed Kandemir EG, Mayadagli A, Karagoz B et al (2005) Prognostic significance of thrombocytosis in node-negative colon cancer. J Int Med Res 33:228–235PubMed
18.
go back to reference Amitrano L, Guardascione MA, Brancaccio V et al (2002) Coagulation disorders in liver disease. Semin Liver Dis 22:83–96PubMedCrossRef Amitrano L, Guardascione MA, Brancaccio V et al (2002) Coagulation disorders in liver disease. Semin Liver Dis 22:83–96PubMedCrossRef
19.
go back to reference Klinger MH, Jelkmann W (2002) Role of blood platelets in infection and inflammation. J Interferon Cytokine Res 22:913–922PubMedCrossRef Klinger MH, Jelkmann W (2002) Role of blood platelets in infection and inflammation. J Interferon Cytokine Res 22:913–922PubMedCrossRef
20.
go back to reference American Joint Cancer Commission (1997) AJCC cancer staging manual. In American Joint Committee on Cancer, 5th edn. Lippincott-Raven, Philadelphia American Joint Cancer Commission (1997) AJCC cancer staging manual. In American Joint Committee on Cancer, 5th edn. Lippincott-Raven, Philadelphia
21.
go back to reference Erdemir F, Kilciler M, Bedir S et al (2007) Clinical significance of platelet count in patients with renal cell carcinoma. Urol Int 79:111–116PubMedCrossRef Erdemir F, Kilciler M, Bedir S et al (2007) Clinical significance of platelet count in patients with renal cell carcinoma. Urol Int 79:111–116PubMedCrossRef
22.
go back to reference Ikeda M, Furukawa H, Imamura H et al (2002) Poor prognosis associated with thrombocytosis in patients with gastric cancer. Ann Surg Oncol 9:287–291PubMedCrossRef Ikeda M, Furukawa H, Imamura H et al (2002) Poor prognosis associated with thrombocytosis in patients with gastric cancer. Ann Surg Oncol 9:287–291PubMedCrossRef
23.
go back to reference 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 25:1427–1433PubMedCrossRef 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 25:1427–1433PubMedCrossRef
24.
go back to reference Benson AB, Choti MA, Cohen AM et al (2000) NCCN practice guidelines for colorectal cancer. Oncology (Williston Park) 14:203–212 Benson AB, Choti MA, Cohen AM et al (2000) NCCN practice guidelines for colorectal cancer. Oncology (Williston Park) 14:203–212
25.
go back to reference 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 22:3408–3419PubMedCrossRef 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 22:3408–3419PubMedCrossRef
26.
go back to reference Blay JY, Favrot M, Rossi JF et al (1993) Role of interleukin-6 in paraneoplastic thrombocytosis. Blood 82:2261–2262PubMed Blay JY, Favrot M, Rossi JF et al (1993) Role of interleukin-6 in paraneoplastic thrombocytosis. Blood 82:2261–2262PubMed
27.
go back to reference Verheul HM, Pinedo HM (2003) The importance of platelet counts and their contents in cancer. Clin Cancer Res 9:3219–3221PubMed Verheul HM, Pinedo HM (2003) The importance of platelet counts and their contents in cancer. Clin Cancer Res 9:3219–3221PubMed
28.
go back to reference 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 6:166–171PubMed 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 6:166–171PubMed
29.
go back to reference 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 77:956–964PubMedCrossRef 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 77:956–964PubMedCrossRef
30.
go back to reference Folman CC, Linthorst GE, van Mourik J et al (2000) Platelets release thrombopoietin (Tpo) upon activation: another regulatory loop in thrombocytopoiesis? Thromb Haemost 83:923–930PubMed Folman CC, Linthorst GE, van Mourik J et al (2000) Platelets release thrombopoietin (Tpo) upon activation: another regulatory loop in thrombocytopoiesis? Thromb Haemost 83:923–930PubMed
31.
go back to reference Jain S, Harris J, Ware J (2010) Platelets: linking hemostasis and cancer. Arterioscler Thromb Vasc Biol 30:2362–2367PubMedCrossRef Jain S, Harris J, Ware J (2010) Platelets: linking hemostasis and cancer. Arterioscler Thromb Vasc Biol 30:2362–2367PubMedCrossRef
32.
go back to reference 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 113:752–760PubMedCrossRef 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 113:752–760PubMedCrossRef
33.
go back to reference 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 59:1295–1300PubMed 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 59:1295–1300PubMed
Metadata
Title
Impact of Preoperative Thrombocytosis on the Survival of Patients with Primary Colorectal Cancer
Authors
Kazuhito Sasaki
Kazushige Kawai
Nelson H. Tsuno
Eiji Sunami
Joji Kitayama
Publication date
01-01-2012
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 1/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-011-1329-7

Other articles of this Issue 1/2012

World Journal of Surgery 1/2012 Go to the issue