Postoperative failure of platelet recovery is an independent risk factor for poor survival in patients with oral and oropharyngeal cancer.
OBJECTIVE
The aim of this study was to evaluate the postoperative platelet count changes in patients with oral and oropharyngeal squamous cell carcinoma undergoing preoperative chemoradiotherapy in order to test the hypothesis that the failure of platelets to recover to normal range within 7 days after surgery represents a significant risk factor for poor survival.


METHODS
A cohort of 102 patients with primary locally advanced oral and oropharyngeal squamous cell carcinoma undergoing neoadjuvant chemoradiotherapy and surgery was retrospectively analyzed. For each patient, platelet counts were evaluated prior to neoadjuvant treatment, prior to surgery and throughout postoperative days 1 to 7. The Kaplan-Meier method and Cox regression models were used to assess the impact of platelet count changes on survival.


RESULTS
Overall survival rate at 5 years was 28% for patients whose platelets did not recover by day 7, with 52% for patients whose platelets remained within a normal level or recovered to this by day 7 (p = 0.005). In multivariate analysis, failure of platelet recovery by day 7 was independently associated with shorter overall survival (p = 0.03).


CONCLUSIONS
We demonstrated that the failure of platelets to recover to normal range by the seventh postoperative day is an independent adverse prognostic factor in patients with oral and oropharyngeal cancer undergoing neoadjuvant treatment and surgery.


CONCLUSIONS
Our results indicate that physicians should pay closer attention to monitoring the postoperative platelet count course, as it may predict the clinical outcome of patients with oral and oropharyngeal cancer.
Department of Cranio-, Maxillofacial and Oral Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. christos.perisanidis@meduniwien.ac.at
Christos
C
Perisanidis
Martina
M
Mittlböck
Alexandra
A
Schoppmann
Gabriela
G
Kornek
Patrick
P
Starlinger
Anton
A
Stift
Edgar
E
Selzer
Christian
C
Schopper
Rolf
R
Ewers
D000368:Aged; D001792:Blood Platelets; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000601:surgery; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality* / Q000601:surgery; D020360:Neoadjuvant Therapy; D009959:Oropharyngeal Neoplasms / Q000401:mortality* / Q000601:surgery; D010976:Platelet Count; D011183:Postoperative Complications; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013921:Thrombocytopenia / Q000401:mortality