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Thromb Haemost 1998; 79(05): 916-918
DOI: 10.1055/s-0037-1615093
Review Article
Schattauer GmbH

Platelet Count and Survival in Patients with Colorectal Cancer – a Preliminary Study

Manuel Monreal
1   From the Departments of Surgery, Medicine and Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
,
Jaume Fernandez-Llamazares
1   From the Departments of Surgery, Medicine and Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
,
Marta Piñol
1   From the Departments of Surgery, Medicine and Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
,
Joan Francesc Julian
1   From the Departments of Surgery, Medicine and Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
,
Marc Broggi
1   From the Departments of Surgery, Medicine and Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
,
Diana Escola
1   From the Departments of Surgery, Medicine and Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
,
Albert Abad
1   From the Departments of Surgery, Medicine and Oncology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
› Author Affiliations
Further Information

Publication History

Received 19 September 1997

Accepted after resubmission 07 January 1998

Publication Date:
07 December 2017 (online)

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Summary

In a previous report we found an inverse correlation between pre-operative platelet count (PlC) levels and the risk of post-operative pulmonary embolism in patients undergoing hip surgery. In the present study, we prospectively evaluated the prognostic significance of pre-operative PlC levels on survival in 180 consecutive patients undergoing surgery for colorectal cancer. Other major clinicopathological parameters studied were age, gender, Dukes’ stage, duration of surgery, pre-operative haemoglobin levels and transfusion requirements.

There were no significant differences in mean pre-operative PlC levels according to tumor stage. Thirty-three patients (18%) died during follow-up (3-23 months, median: 13 months). Univariate analysis (Kaplan-Meier estimates) showed that advanced tumor stage (p <0.001), duration of surgery (p <0.05) and a high pre-operative PlC level (p <0.001) were significantly associated to a poor survival. The multivariate Cox analysis revealed that tumor stage (RR:5.734; 95%C.I.: 2.644-12.44), a high pre-operative PlC level (RR: 2.467; 95%C.I.: 1.117-5.452), and to a lesser extent the patients’ age remained independent prognostic variables for mortality. The findings of this preliminary study may be of interest from the point of view of pathogenesis, but also clinically, since they might be used in the decision as to which patients or groups of patients should receive more aggressive therapeutic intervention.

 

  • References

  • 1 Monreal M, Lafoz E, Roca J, Granero X, Soler JM, Salazar X. et al. Platelet count, antiplatelet therapy and pulmonary embolism. A prospective study in patients with hip surgery. Thromb Haemost 1995; 73: 380-5.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Monreal M, Lafoz E, Llamazares J, Roncalés J, Roca J, Granero X. Preoperative platelet count and postoperative blood loss in patients undergoing hip surgery. An inverse correlation. Haemostasis 1996; 26: 164-9.
    PubMedGoogle Scholar
  • 3 Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 53: 457-81.
    CrossrefPubMedGoogle Scholar
  • 4 Peto R, Pike MC, Armitage P, Breslow NE, Cox DR, Howard SV. et al. Design and analysis of randomized clinical trials requiring prolonged observation of each patient, II: analysis and examples. Br J Cancer 1977; 35: 1-39.
    CrossrefPubMedGoogle Scholar
  • 5 Statistics and epidemiology research corporation and Cytel software corporation: EGRET. Reference manual, 1990.
    PubMedGoogle Scholar
  • 6 Cox DR. Regression models and life-tables. J R Stat Soc B 1972; 34: 187-220.
    PubMedGoogle Scholar
  • 7 Hernandez E, Lavine M, Dunton CJ, Gracely E, Parker J. Poor prognosis associated with thrombocytosis in patients with cervical cancer. Cancer 1992; 69: 2975-7.
    CrossrefPubMedGoogle Scholar
  • 8 Rodriguez GC, Clarke-Pearson DL, Soper JT, Berchuk A, Synan I, Dodge RK. The negative prognostic implications of thrombocytosis in women with stage IB cervical cancer. Obstet Gynecol 1994; 83: 445-8.
    PubMedGoogle Scholar
  • 9 Lopes A, Daras V, Cross PA, Robertson G, Beynon G, Monaghan JM. Thrombocytosis as a prognostic factor in women with cervical cancer. Cancer 1994; 74: 90-2.
    CrossrefPubMedGoogle Scholar
  • 10 Hernandez E, Heller PB, Whitney C, Diana K, Delgado G. Thrombocytosis in surgically treated stage IB squamous cell cervical carcinoma (A gyneco-logic oncology group study). Gynecol Oncol 1994; 55: 328-32.
    CrossrefPubMedGoogle Scholar
  • 11 Zeimet AG, Marth C, Müller-Holzner E, Daxenbichler G, Dapunt O. Significance of thrombocytosis in patients with epithelial ovarian cancer. Am J Obstet Gynecol 1994; 170: 549-54.
    CrossrefPubMedGoogle Scholar
  • 12 Sagman U, Maki E, Evans WK, Warr D, Shepherd FA, Sculier JP. et al. Small-cell carcinoma of the lung: derivation of a prognostic staging system. J Clin Oncol 1991; 9: 1639-49.
    CrossrefPubMedGoogle Scholar
  • 13 Quoix E, Hedelin G, Popin E, Charloux A, Dietemann A, Seibert R. et al. Can we predict very short term survival in small cell lung cancer?. Lung Cancer 1993; 10: 229-38.
    CrossrefPubMedGoogle Scholar
  • 14 Pedersen LM, Milman N. Prognostic significance of thrombocytosis in patients with primary lung cancer. Eur Respir J 1996; 9: 1826-30.
    CrossrefPubMedGoogle Scholar
  • 15 Davis RB, Theologides A, Kennedy BJ. Comparative studies of blood coagulation and platelet aggregation in patients with cancer and nonmalignant diseases. Ann Intern Med 1969; 71: 67-80.
    CrossrefPubMedGoogle Scholar
  • 16 Brugarolas A, Mink IB, Elias EG, Mittelman A. Correlation of hyperfibrinogenemia with major thromboembolism in patients with cancer. Surg Gyn Obstet 1973; 136: 75-7.
    PubMedGoogle Scholar
  • 17 Editorial.. Haemostatic abnormalities and malignant disease. Lancet 1986; 1: 303-4.
    PubMedGoogle Scholar
  • 18 Edwards RL, Rickles FR, Moritz TE, Henderson WG, Zacharski LR, Forman WB. et al. Abnormalities of blood coagulation tests in patients with cancer. Am J Clin Pathol 1987; 88: 596-602.
    CrossrefPubMedGoogle Scholar
  • 19 Costantini V, Zacharski LR, Moritz TE, Edwards RL. The platelet count in carcinoma of the lung and colon. Thromb Haemost 1990; 64: 501-5.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Falanga A, Barbui T, Rickles FR, Levine MN. Guidelines for clotting studies in cancer patients. Thromb Haemost 1993; 70: 540-2.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Davis WM, Ross AOM. Thrombocytosis and thrombocytemia: the clinical and laboratory significance of an elevated platelet count. Am J Clin Pathol 1973; 59: 243-7.
    CrossrefPubMedGoogle Scholar
  • 22 Schilling RF. Platelet millionaires. Lancet 1980; 2: 372-3.
    PubMedGoogle Scholar
  • 23 Estrov Z, Talpaz M, Mavligit G, Pazdur R, Harris D, Greenberg SM. Elevated plasma thrombopoietic activity in patients with metastatic cancer-related thrombocytosis. Amer J Med 1995; 98: 551-8.
    CrossrefPubMedGoogle Scholar
  • 24 Iversen LH, Okholm M, Thorlacius Ussing O. Pre- and postoperative state of coagu-lation and fibrinolysis in plasma of patients with benign and malignant colorectal disease- A preliminary Study. Thromb Haemost 1996; 76: 523-8.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Edwards CM, Warren J, Armstrong L, Donnelly PK. D-dimer: a useful marker of disease stage in surgery for colorectal cancer. Br J Surg 1993; 80: 1404-5.
    CrossrefPubMedGoogle Scholar
  • 26 Iversen LH, Thorlacius-Ussing O, Okholm M. Soluble fibrin in plasma before and after surgery for benign and malignant colorectal disease. Thromb Res 1995; 79: 471-581.
    CrossrefPubMedGoogle Scholar
  • 27 Kakkar AK, DeRuvo N, Chinswangwatanakul V, Tebbutt S, Williamson RCN. Extrinsic-pathway activation in cancer with high factor VIIa and tissue factor. Lancet 1995; 346: 1004-5.
    CrossrefPubMedGoogle Scholar
  • 28 Tuszynski GP, Gasic TB, Rothman VL, Knudsen KA, Gasic GJ. Thrombospondin, a potentiator of tumor cell metastasis. Cancer Res 1987; 47: 4130-3.
    PubMedGoogle Scholar
  • 29 Boukerche H, Berthier-Vergnes O, Bailly M, Doré JF, Leung LLK, McGregor JL. A monoclonal antibody (LYP18) directed against the blood platelet glycoprotein IIb/IIIa complex inhibits human melanoma growth in vivo. Blood 1989; 74: 909-12.
    PubMedGoogle Scholar
  • 30 Nierodzyk ML, Bain RM, Liu LX, Shivji M, Takeshita K, Karpatkin S. Presence of the seven transmembrane thrombin receptor on human tumour cells: effect of activation on tumour adhesion to platelets and tumour tyrosine phosphorilation. Brit J Haematol 1996; 92: 452-7.
    CrossrefPubMedGoogle Scholar
  • 31 Monreal M, Lafoz E, Casals A, Ruiz J, Arias A. Platelet count and venous thrombo-embolism. A useful test for suspected pulmonary embolism. Chest 1991; 100: 1493-6.
    CrossrefPubMedGoogle Scholar
  • 32 Monreal M, Lafoz E, Ruiz J, Gimenez G. Platelet count in acute pulmonary embolism: its relationship to recurrences. Haemostasis 1993; 23: 263-8.
    PubMedGoogle Scholar
  • 33 Monreal M, Urrutia A, Martí S, Cuxart A, Roncalés J. Platelet count and the risk of bleeding in hospitalized patients with venous thromboembolism starting anticoagulant therapy. Haemostasis 1997; 27: 91-8.
    PubMedGoogle Scholar