The significance of thrombocytosis in patients with locally advanced cervical carcinoma: a Gynecologic Oncology Group study.
OBJECTIVE
The aim of this study was to determine the incidence of thrombocytosis and its possible impact on survival probability among women with locally advanced cervical carcinoma.


METHODS
The database of 294 patients with Stages IIB-IVA cervical carcinoma without periaortic node metastasis who were treated with standardized radiation therapy and concurrent hydroxyurea or misonidazole was analyzed. Pretreatment platelet counts were available for 291 patients who are the subject of this study.


RESULTS
Thrombocytosis (platelet count >400 x 10(9)/liter) was present in 86 (29.6%) of the 291 patients. A multivariate Cox proportional hazards model showed that patients without extrapelvic disease and with thrombocytosis had a 55% greater chance of dying than those without thrombocytosis (relative risk = 1.55, 95% confidence interval 1.08-2.21). Patients with thrombocytosis had larger tumors and more frequently had bilateral parametrial involvement, tumor fixation to the sidewall, and positive pelvic lymph nodes than patients without thrombocytosis. Thrombocytosis was not found to be a prognostic factor in patients with positive pelvic nodes. However, in patients with negative pelvic nodes, the presence or absence of thrombocytosis was related to survival.


CONCLUSIONS
Thrombocytosis is a frequent finding among patients with advanced cervical carcinoma and seems to be related to tumor burden. Among patients with locally advanced cervical carcinoma who had negative pelvic nodes, those with thrombocytosis had a poorer survival.
Division of Gynecologic Oncology, MCP-Hahnemann School of Medicine, Philadelphia, Pennsylvania 19131, USA.
E
E
Hernandez
K A
KA
Donohue
L L
LL
Anderson
P B
PB
Heller
F B
FB
Stehman
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D015994:Incidence; D008197:Lymph Node Excision; D008875:Middle Aged; D008920:Misonidazole / Q000627:therapeutic use; D015337:Multicenter Studies as Topic; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D016016:Proportional Hazards Models; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D013922:Thrombocytosis / Q000209:etiology / Q000401:mortality*; D002583:Uterine Cervical Neoplasms / Q000097:blood* / Q000401:mortality* / Q000628:therapy
D000970:Antineoplastic Agents; D011838:Radiation-Sensitizing Agents; D008920:Misonidazole; D006918:Hydroxyurea