title: Impact of pretreatment thrombocytosis on blood-borne metastasis and prognosis of gastric cancer.
abstract: BACKGROUND
  Thrombocytosis has been associated with malignancies and poor prognostic implications in cancer patients. In the present study the prognostic significance of pretreatment platelet (PLT) level was assessed with regard to recurrence and survival in patients with primary gastric adenocarcinoma.
  
  
  METHODS
  The authors reviewed the prospective data of 1593 gastric cancer patients who received curative gastrectomy with extended lymphadenectomy. The correlations of PLT level with recurrence and overall survival were evaluated by both univariate and multivariate analyses.
  
  
  RESULTS
  Thrombocytosis (≥ 40 × 10(4)/ μL), present in 6.4% of the patients prior to curative surgery, was more frequently associated with advanced T and N classification, larger tumor size, anemia, and leukocytosis (p < 0.05). In patients with pretreatment thrombocytosis compared to those without it, five-year survival rate was worse (56.9% vs. 65.5%; p = 0.043), and recurrence rate was higher mainly due to the frequent hematogenous spread (51.0% vs. 34.5%; p < 0.001). Furthermore, risk of blood-borne metastasis was almost three-fold higher in patients with pretreatment thrombocytosis (Odds ratio 2.83 [95% CI 1.67-4.77], p < 0.001).
  
  
  CONCLUSIONS
  Pretreatment thrombocytosis correlated significantly with poor prognosis and can be used as an independent predictor of recurrence by blood-borne metastasis in gastric cancer.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Republic of Korea.
authors.forename: S G
authors.initials: SG
authors.lastname: Hwang
authors.forename: K M
authors.initials: KM
authors.lastname: Kim
authors.forename: J H
authors.initials: JH
authors.lastname: Cheong
authors.forename: H I
authors.initials: HI
authors.lastname: Kim
authors.forename: J Y
authors.initials: JY
authors.lastname: An
authors.forename: W J
authors.initials: WJ
authors.lastname: Hyung
authors.forename: S H
authors.initials: SH
authors.lastname: Noh
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D000704:Analysis of Variance; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating; D016017:Odds Ratio; D015539:Platelet Activation; D010976:Platelet Count; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D013922:Thrombocytosis / Q000150:complications*