Prognostic significance of platelet count in HCC patients adjusted for surrogate parameters of portal hypertension

Background Complications of portal hypertension such as ascites and variceal bleeding represent a frequent obstacle to the treatment of patients with hepatocellular carcinoma (HCC). However, it was recently shown that elevated platelet volume and low platelet count an established surrogate marker of portal hypertension, correlates with better survival in patients with advanced HCC. Due to the uncertain significance of platelet count in determining patients’ outcome, we aimed at assessing its prognostic significance by a multivariate analysis comprising independent indicators of portal hypertension.

Aims and Methods To this aim, we analyzed data of 364 consecutive patients diagnosed with HCC prospectively collected between 2012 and 2016 and retrieved from the CREDOS database at our institution. A multivariate analysis comprising several clinical variables including variceal status as well as spleen size was performed to assess the prognostic significance of platelet count independently of its significance as a marker of portal hypertension.

Results Multivariate analysis revealed low platelet numbers to be an independent predictor of survival (OR 1.003; 95 %CI 1.001-1.005; p = 0.014) regardless of the effect of spleen size and variceal status.

Conclusion Our data confirm previous reports suggesting that platelets might negatively affect the patient’s outcome by interacting with the tumor microenvironment and favoring tumor proliferation or metastasis. This data warrants further investigations of the molecular pathways underlying this phenomenon.

Publication History

Article published online:
10 June 2021