Is there a role for pre-operative thrombocytosis in the management of colorectal cancer?
BACKGROUND
High circulating platelet counts have been associated with poor prognosis in a variety of solid tumours such as breast, renal and lung cancer. We investigated the significance of a high pre-operative platelet count on overall survival in patients with stages I-IV colorectal cancer.


METHODS
630 Consecutive patients who colorectal cancer resection between 2004 and 2007 with a full blood count taken 14 days prior to the surgery were assessed. Male:female 7:5, median (range) age 73 (40-99 years). Thrombocytosis was defined as platelet count of ≥450 × 10(9)/L. The relationship between platelet count, pathological features and overall survival was assessed.


RESULTS
: Mantel-Cox regression showed that platelet count does not predict survival on multivariate analysis (p = 0.067). Thrombocytosis was present in 51/627 (8.1%) of cases. There was no statistically significant difference in mean survival (p = 0.067) observed in patients with platelet count <450 × 10(9)/L (n = 576; 95%CI: 1550.5-1405.4 SE 37.0) versus ≥450 × 10(9)/L (n = 51, CI: 1261.6-955.0, SE 78.2). There was also no correlation between Dukes stage and thrombocytosis.


CONCLUSIONS
In our study, pre-operative thrombocytosis is not a prognostic indicator of survival in colorectal cancer patients regardless of pathological stage.
Nyasavajjala
Sitaramachandra Murthy
SM
Derby GEM School of Medicine and Health, University of Nottingham, UK. sitaramachandra.nyasavajjala@nottingham.ac.uk
Runau
Francois
F
Datta
Sayan
S
Annette
Haines
H
Shaw
Aidan G
AG
Lund
Jonathan N
JN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013922:Thrombocytosis / Q000097:blood / Q000150:complications*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult