title: Pretreatment thrombocytosis as a prognostic factor in women with gynecologic malignancies: a meta-analysis.
abstract: BACKGROUND
  This study was performed to analyze the prognostic implications of pretreatment or preoperative thrombocytosis in women with gynecologic malignancies.
  
  
  METHODS
  We surveyed 2 medical databases, PubMed and EMBASE, to identified all relevant studies. A total of 14 (n=3,490) that evaluated the link between thrombocytosis and 5-year survival were included. REVMAN version 5.1 was used for our analysis and publication bias was evaluated using the Begg's funnel plot and tested by STATA 11.0. Risk ratios (RRs) with 95% confidence intervals (CIs) generated by the random effect model were used to assess the strength of any association.
  
  
  RESULTS
  709(20.3%) of the 3,490 patients exhibited thrombocytosis (platelet counts >400?109/L) at primary diagnosis, and their mortality was 1.62-fold higher compared with the others (RR=1.62, 95%CI= [1.28- 2.05], p<0.0001). Thrombocytosis failed to have a stronger effect on the survival of advanced patients of stages III to IV in our study (n=478, RR=1.29, 95% CI= [1.13-1.48], p=0.0003), nor in women with cervical cancer in stage IB (n=1371, RR= 1.73, 95% CI= [1.71-2.58], p=0.007). In addition, when adjusted for different carcinoma, it was associated with worse prognosis for all except the ones with vulvar cancer (n=201, RR= 0.43, 95% CI= [0.14-1.29], p=0.13).
  
  
  CONCLUSIONS
  This meta-analysis indicated that thrombocytosis might be associated with a worse prognosis for patients with gynecologic malignancies but without specificity or sensitivity for the ones in advanced stage. When adjusted for different gynecologic malignancies, it showed a significant effect on survival of all except vulvar cancers.
authors: Department of Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
authors: Min
authors: M
authors: Yu
authors: Lei
authors: L
authors: Liu
authors: Bing-Lan
authors: BL
authors: Zhang
authors: Qi
authors: Q
authors: Chen
authors: Xue-Lei
authors: XL
authors: Ma
authors: Yu-Ke
authors: YK
authors: Wu
authors: Chun-Shui
authors: CS
authors: Liang
authors: Zhi-Min
authors: ZM
authors: Niu
authors: Xin
authors: X
authors: Qin
authors: Ting
authors: T
authors: Niu
mesh_terms: D005260:Female; D005833:Genital Neoplasms, Female; D006801:Humans; D010976:Platelet Count; D011379:Prognosis; D013922:Thrombocytosis; D014846:Vulvar Neoplasms