Poor prognosis associated with thrombocytosis in patients with renal cell carcinoma.
OBJECTIVE
To better define the relationship between platelet count and survival using a retrospective analysis in patients with thrombocytosis and metastatic renal cell carcinoma (RCC), some of whom had a shorter life expectancy than those with a normal platelet count.


METHODS
The records were reviewed of patients with stage IV RCC who had undergone a variety of adjuvant therapies after nephrectomy between 1972 and 1992. Entry criteria included a tissue diagnosis of RCC, at least one platelet count and a complete follow-up until the time of death. Of 350 patients available for review, 259 met the entry criteria. Patients were divided into two groups: group 1 included 112 patients whose platelet counts remained at < 4 x 105/microL between the time of nephrectomy and the time of death; group 2 included 147 patients with at least one platelet count of > 4 x 105/microL (mean age in each group 57 years).


RESULTS
The mean (SD) survival for group 1 was 151 (34) months, compared with 92 (18) months for those in group 2. Using the log-rank chi-square test the difference in survival between the groups was significant (P = 0.005). Controlling for established prognostic indicators of pathological stage, nuclear grade and cell type, using Cox's regression technique, the difference in survival between the groups remained significant (P = 0.015).


CONCLUSIONS
These results suggest that patients with metastatic RCC who receive adjuvant therapy and have a persistently normal platelet count have a 64% longer life expectancy than those with thrombocytosis. The difference is highly statistically significant when controlled for nuclear grade, cell type and pathological stage.
Department of Urology, Emory University School of Medicine, Atlanta, Georgia, and The Virginia Medical Center, USA.
N P
NP
Symbas
M F
MF
Townsend
R
R
El-Galley
T E
TE
Keane
S D
SD
Graham
J A
JA
Petros
D002292:Carcinoma, Renal Cell / Q000150:complications / Q000401:mortality* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D007680:Kidney Neoplasms / Q000150:complications / Q000401:mortality* / Q000628:therapy; D009392:Nephrectomy / Q000379:methods; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013922:Thrombocytosis / Q000209:etiology / Q000401:mortality*