title: Preoperative platelet count and survival prognosis in resected pancreatic ductal adenocarcinoma.
abstract: BACKGROUND
  High platelet counts are associated with an adverse effect on survival in various neoplastic entities. The prognostic relevance of preoperative platelet count in pancreatic cancer has not been clarified.
  
  
  METHODS
  We performed a retrospective review of 205 patients with ductal adenocarcinoma who underwent surgical resection between 1990 and 2003. Demographic, surgical, and clinicopathologic variables were collected. A cutoff of 300,000/mul was used to define high platelet count.
  
  
  RESULTS
  Of the 205 patients, 56 (27.4%) had a high platelet count, whereas 149 patients (72.6%) comprised the low platelet group. The overall median survival was 17 (2-178) months. The median survival of the high platelet group was 18 (2-137) months, and that of the low platelet group was 15 (2-178) months (p = 0.7). On multivariate analysis, lymph node metastasis, vascular invasion, positive margins, and CA 19-9 > 200 U/ml were all significantly associated with poor survival.
  
  
  CONCLUSIONS
  There is no evidence to support preoperative platelet count as either an adverse or favorable prognostic factor in pancreatic ductal adenocarcinoma. Use of 5-year actual survival data confirms that lymph node metastases, positive margins, vascular invasion, and CA 19-9 are predictors of poor survival in resected pancreatic cancer.
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Wang Ambulatory Care Center 460, 15 Parkman Street, Boston, Massachusetts 02114, USA.
authors.forename: Ismael
authors.initials: I
authors.lastname: Domínguez
authors.forename: Stefano
authors.initials: S
authors.lastname: Crippa
authors.forename: Sarah P
authors.initials: SP
authors.lastname: Thayer
authors.forename: Yin P
authors.initials: YP
authors.lastname: Hung
authors.forename: Cristina R
authors.initials: CR
authors.lastname: Ferrone
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Warshaw
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernández-Del Castillo
mesh_terms: D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery*; D010976:Platelet Count; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis