title: Thrombocytopenia for prediction of hepatocellular carcinoma recurrence: Systematic review and meta-analysis.
abstract: OBJECTIVE
  To investigate the association between thrombocytopenia and relapse after treatment for hepatocellular carcinoma (HCC).
  
  
  METHODS
  We searched the PubMed, EMBASE, and Web of Science databases to obtain eligible studies. The hazard ratios (HRs) values and 95% confidence intervals (CIs) were pooled by random effects model. Subsequently, we estimated the heterogeneity, performed a sensitivity analysis, determined the publication bias, and performed subgroup and meta-regression analyses. Study quality was assessed by using the Oxford Center for Evidence Based Medicine tool.
  
  
  RESULTS
  We identified 18 eligible studies by retrieval (published during 2000-2014). Out of the 4163 patients with HCC who were recruited, 2746 (66.0%) experienced recurrence. In general, our meta-analysis suggested that low platelet count (PLT) before therapy significantly increased the probability of postoperative recurrence (HR = 1.53, 95%CI: 1.29-1.81). PLT was also valuable in the prediction of intrahepatic distant recurrence (HR = 1.49, 95%CI: 1.25-1.77). Subgroup and meta-regression analyses identified various therapeutic modalities as the source of a high degree of heterogeneity. The pooled HR values showed no obvious change when a single study was removed, but otherwise, an opposite-effects model was used. In addition, no significant publication bias was detected.
  
  
  CONCLUSIONS
  Thrombocytopenia before treatment might be an inexpensive and useful predictor of postoperative recurrence in patients with HCC.
authors.affiliation: Qing Pang, Kai Qu, Jian-Bin Bi, Su-Shun Liu, Jing-Yao Zhang, Si-Dong Song, Ting Lin, Xin-Sen Xu, Yong Wan, Ming-Hui Tai, Hao-Chen Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Pang
authors.affiliation: Qing Pang, Kai Qu, Jian-Bin Bi, Su-Shun Liu, Jing-Yao Zhang, Si-Dong Song, Ting Lin, Xin-Sen Xu, Yong Wan, Ming-Hui Tai, Hao-Chen Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Qu
authors.affiliation: Qing Pang, Kai Qu, Jian-Bin Bi, Su-Shun Liu, Jing-Yao Zhang, Si-Dong Song, Ting Lin, Xin-Sen Xu, Yong Wan, Ming-Hui Tai, Hao-Chen Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Jian-Bin
authors.initials: JB
authors.lastname: Bi
authors.affiliation: Qing Pang, Kai Qu, Jian-Bin Bi, Su-Shun Liu, Jing-Yao Zhang, Si-Dong Song, Ting Lin, Xin-Sen Xu, Yong Wan, Ming-Hui Tai, Hao-Chen Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Su-Shun
authors.initials: SS
authors.lastname: Liu
authors.affiliation: Qing Pang, Kai Qu, Jian-Bin Bi, Su-Shun Liu, Jing-Yao Zhang, Si-Dong Song, Ting Lin, Xin-Sen Xu, Yong Wan, Ming-Hui Tai, Hao-Chen Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Jing-Yao
authors.initials: JY
authors.lastname: Zhang
authors.affiliation: Qing Pang, Kai Qu, Jian-Bin Bi, Su-Shun Liu, Jing-Yao Zhang, Si-Dong Song, Ting Lin, Xin-Sen Xu, Yong Wan, Ming-Hui Tai, Hao-Chen Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Si-Dong
authors.initials: SD
authors.lastname: Song
authors.affiliation: Qing Pang, Kai Qu, Jian-Bin Bi, Su-Shun Liu, Jing-Yao Zhang, Si-Dong Song, Ting Lin, Xin-Sen Xu, Yong Wan, Ming-Hui Tai, Hao-Chen Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Lin
authors.affiliation: Qing Pang, Kai Qu, Jian-Bin Bi, Su-Shun Liu, Jing-Yao Zhang, Si-Dong Song, Ting Lin, Xin-Sen Xu, Yong Wan, Ming-Hui Tai, Hao-Chen Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Xin-Sen
authors.initials: XS
authors.lastname: Xu
authors.affiliation: Qing Pang, Kai Qu, Jian-Bin Bi, Su-Shun Liu, Jing-Yao Zhang, Si-Dong Song, Ting Lin, Xin-Sen Xu, Yong Wan, Ming-Hui Tai, Hao-Chen Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wan
authors.affiliation: Qing Pang, Kai Qu, Jian-Bin Bi, Su-Shun Liu, Jing-Yao Zhang, Si-Dong Song, Ting Lin, Xin-Sen Xu, Yong Wan, Ming-Hui Tai, Hao-Chen Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Ming-Hui
authors.initials: MH
authors.lastname: Tai
authors.affiliation: Qing Pang, Kai Qu, Jian-Bin Bi, Su-Shun Liu, Jing-Yao Zhang, Si-Dong Song, Ting Lin, Xin-Sen Xu, Yong Wan, Ming-Hui Tai, Hao-Chen Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Hao-Chen
authors.initials: HC
authors.lastname: Liu
authors.affiliation: Qing Pang, Kai Qu, Jian-Bin Bi, Su-Shun Liu, Jing-Yao Zhang, Si-Dong Song, Ting Lin, Xin-Sen Xu, Yong Wan, Ming-Hui Tai, Hao-Chen Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Ya-Feng
authors.initials: YF
authors.lastname: Dong
authors.affiliation: Qing Pang, Kai Qu, Jian-Bin Bi, Su-Shun Liu, Jing-Yao Zhang, Si-Dong Song, Ting Lin, Xin-Sen Xu, Yong Wan, Ming-Hui Tai, Hao-Chen Liu, Chang Liu, Department of Hepatobiliary Surgery, the First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Chang
authors.initials: C
authors.lastname: Liu
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000556:secondary / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D016017:Odds Ratio; D010976:Platelet Count; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D013921:Thrombocytopenia / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D016896:Treatment Outcome
keywords: Blood platelets; Hepatocellular carcinoma; Prognosis; Recurrence; Thrombocytopenia