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Preoperative Platelet Count Associates with Survival and Distant Metastasis in Surgically Resected Colorectal Cancer Patients

  • Original Research
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Abstract

Objective

Platelets have been implicated in cancer metastasis and prognosis. No population-based study has been reported as to whether preoperative platelet count directly predicts metastatic recurrence of colorectal cancer (CRC) patients.

Design

Using a well-characterized cohort of 1,513 surgically resected CRC patients, we assessed the predictive roles of preoperative platelet count in overall survival, overall recurrence, as well as locoregional and distant metastatic recurrences.

Results

Patients with clinically high platelet count (≥400 × 109/L) measured within 1 month before surgery had a significantly unfavorable survival (hazard ratio [HR] = 1.66, 95 % confidence interval [CI] 1.34–2.05, P = 2.6 × 10−6, P log rank = 1.1 × 10−11) and recurrence (HR = 1.90, 1.24–2.93, P = 0.003, P log rank = 0.003). The association of platelet count with recurrence was evident only in patients with metastatic (HR = 2.81, 1.67–4.74, P = 1.1 × 10−4, P log rank = 2.6 × 10−6) but not locoregional recurrence (HR = 0.59, 95 % CI 0.21–1.68, P = 0.325, P log rank = 0.152). The findings were internally validated through bootstrap resampling (P < 0.01 at 98.6 % of resampling). Consistently, platelet count was significantly higher in deceased than living patients (P < 0.0001) and in patients with metastatic recurrence than locoregional (P = 0.004) or nonrecurrent patients (P < 0.0001). Time-dependent modeling indicated that the increased risks for death and metastasis associated with elevated preoperative platelet counts persisted up to 5 years after surgery.

Conclusion

Our data demonstrated that clinically high level of preoperative platelets was an independent predictor of CRC survival and metastasis. As an important component of the routinely tested complete blood count panel, platelet count may be a cost-effective and noninvasive marker for CRC prognosis and a potential intervention target to prevent metastatic recurrence.

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Acknowledgments

The work was supported by National Cancer Institute Grants CA153099, CA152703, and CA162201 and a Research Scholar Award from the V Foundation for Cancer Research.

Conflict of Interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Population Science, Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, 19107, USA

    Shaogui Wan, Yinzhi Lai, Ronald E. Myers, Kejin Zhang & Hushan Yang

  2. Center for Human Genetics Research, Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, 37232, USA

    Bingshan Li

  3. Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, 19107, USA

    Terry Hyslop

  4. Department of Cancer Biology, Thomas Jefferson University, Philadelphia, PA, 19107, USA

    Jack London & Devjani Chatterjee

  5. Department of Pathology, Thomas Jefferson University, Philadelphia, PA, 19107, USA

    Juan P. Palazzo & Ashlie L. Burkart

  6. Department of Cell Biology, Fourth Military Medical University, Xi’an, 710032, China

    Jinliang Xing

Authors
  1. Shaogui Wan
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  2. Yinzhi Lai
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  3. Ronald E. Myers
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  10. Kejin Zhang
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Corresponding author

Correspondence to Hushan Yang.

Additional information

Shaogui Wan and Yinzhi Lai contributed equally to this manuscript.

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Wan, S., Lai, Y., Myers, R.E. et al. Preoperative Platelet Count Associates with Survival and Distant Metastasis in Surgically Resected Colorectal Cancer Patients. J Gastrointest Canc 44, 293–304 (2013). https://doi.org/10.1007/s12029-013-9491-9

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  • DOI: https://doi.org/10.1007/s12029-013-9491-9

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