title: The prognostic significance of the preoperative full blood count after resection of colorectal liver metastases.
abstract: BACKGROUND
  Increased preoperative platelet and neutrophil counts are risk factors for decreased survival in several different malignancies. Our aim was to investigate the relationship between overall or disease-free survival after resection of CRLM and the preoperative haematological parameters.
  
  
  METHODS
  We reviewed a cohort of 140 patients who underwent resection of CRLM with curative intent, utilising prospectively maintained databases. Patient demographics, operative details, FBC, CRP, INR, histopathology results, and survival data were examined. Kaplan-Meier survival and Cox regression analyses were used to determine the impact of all variables on survival.
  
  
  RESULTS
  140 patients (96 males) with a median age of 67 years (range 33-82 years) underwent resection of CRLM. A significant correlation was exhibited between preoperative platelet count and neutrophil count (rho = 0.186, P = .028). When modelled as continuous covariates in a Cox regression hazards, an increased preoperative platelet (P = .02) and neutrophil counts (P <or= .001) were significantly associated with overall survival. Of the haematological parameters assessed only preoperative platelet count showed a strong trend of association with disease free survival; however this failed to reach statistical significance (P = .076).
  
  
  CONCLUSIONS
  Increased preoperative platelet and neutrophil counts are independent risk factors for decreased survival in patients undergoing resection of CRLM in our series of patients. These findings require validation in larger studies to determine their relationship with survival. Further research into the role of these cell types in tumour progression, particularly in the development and inhibition of angiogenesis, is warranted.
authors.affiliation: Department of Surgery, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK. kdajani@liv.ac.uk
authors.forename: K
authors.initials: K
authors.lastname: Dajani
authors.forename: D A
authors.initials: DA
authors.lastname: O'Reilly
authors.forename: N De Liguori
authors.initials: NL
authors.lastname: Carino
authors.forename: P
authors.initials: P
authors.lastname: Ghaneh
authors.forename: G
authors.initials: G
authors.lastname: Poston
authors.forename: A
authors.initials: A
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001772:Blood Cell Count; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate