Thrombocytosis as a predictor of distant recurrence in patients with rectal cancer.
OBJECTIVE
Thrombocytosis is frequently observed in patients with malignancy. We undertook this study to determine the prognostic value of thrombocytosis in patients with rectal cancer.


METHODS
We performed a retrospective study of patients undergoing low anterior resection for rectal cancer between January 2000 and March 2007. Preoperative platelet count was measured before surgery. Postoperative platelets were determined 1 month after surgery. Two-tailed p values <0.05 were considered statistically significant.


RESULTS
One hundred sixty three patients with rectal cancer were included in the study. Preoperative platelet count >350,000 was found in 8% of patients. Postoperative platelet count >350,000 was found in 6% of patients. Distant metastases were found in 17 patients (10.4%). Significant variables in the multivariate analyses were preoperative platelets >350,000 (p = 0.001), postoperative platelets >350,000 (p = 0.002), carcinoembryonic antigen >13 ng/dL (p = 0.003). Patients with preoperative platelet count <350,000 showed a 5-year survival rate of 81%, whereas patients with platelet count >350,000 had a 25-month survival [95% confidence interval (CI): 20-26]; p <0.001. Patients with postoperative platelets <350,000 showed a 5-year survival rate of 80%, whereas patients with platelets >350,000 showed a 3-year survival rate of 37.5% (p <0.05).


CONCLUSIONS
Pre- or postoperative platelet count >350,000 is associated with poor survival in patients with rectal cancer. The measurement of platelets is a clinical marker useful to define the prognosis for patients with rectal cancer.
Colon and Rectum Service, Division of Surgical Oncology, Hospital de Oncologia, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico. adriancravioto@mac.com
Adrian
A
Cravioto-Villanueva
Pedro
P
Luna-Perez
Marco
M
Gutierrez-de la Barrera
Hector
H
Martinez-Gómez
Antonio
A
Maffuz
Priscila
P
Rojas-Garcia
Claudia
C
Perez-Alvarez
Saúl
S
Rodriguez-Ramirez
Edgar
E
Rodriguez-Antezana
Lourdes
L
Ramirez-Ramirez
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000097:blood* / Q000556:secondary / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000453:epidemiology / Q000556:secondary; D008175:Lung Neoplasms / Q000453:epidemiology / Q000556:secondary; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010976:Platelet Count; D011379:Prognosis; D012004:Rectal Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate; D013922:Thrombocytosis / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult