title: Kinetics of postdiagnosis platelet count with overall survival of pancreatic cancer: a counting process approach.
abstract: The association between long-term variation of postdiagnosis platelets and survival of pancreatic cancer (PC) has never been discussed by using dynamic survival analysis method. In this retrospective study, we analyzed 311 histologically confirmed PC patients identified from a mega population-based electronic inpatients database from 2012 to 2013 in China. Counting process approach was applied to restructure the original survival data, the association between post-diagnosis platelet count and overall survival (OS) of PC was evaluated by multiple failure-time Cox proportional hazards model. After counting process adjustment, multiple failure-time Cox proportional hazards model revealed that, regardless of the treatment modalities PC patients received, postdiagnosis thrombocytopenia was prominently associated with OS, compared with PC patients with normally ranged platelet count, the HRs ranged from 2.04 (95% CI: 1.14-3.67) to 10.82 (95% CI: 2.63-44.54), and this inverse association was robust based on further sensitivity analysis. On the contrary, the association between thrombocytosis and OS of PC tended to be inconclusive. Our findings suggested that postdiagnosis thrombocytopenia was associated with significantly compromised survival among PC patients from this large retrospective cohort. Underlying mechanisms behind this association should be further investigated.
authors: Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.|School of Public Health, Kunming Medical University, Kunming, Yunnan, China.
authors: Yuanyuan
authors: Y
authors: Xiao
authors: Health Information Center, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China.
authors: Hua
authors: H
authors: Xie
authors: Health Information Center, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China.
authors: Zhihui
authors: Z
authors: Xie
authors: Health Information Center, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China.
authors: Zhenyi
authors: Z
authors: Shao
authors: Health Information Center, Shanghai Municipal Commission of Health and Family Planning, Shanghai, China.
authors: Wen
authors: W
authors: Chen
authors: Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.|Key Lab of Health Technology Assessment, Ministry of Health (Fudan University), Shanghai, China.
authors: Guoyou
authors: G
authors: Qin
authors: Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.|Key Lab of Health Technology Assessment, Ministry of Health (Fudan University), Shanghai, China.
authors: Naiqing
authors: N
authors: Zhao
mesh_terms: D000368:Aged; D017024:Chemotherapy, Adjuvant; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D010976:Platelet Count; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis; D013921:Thrombocytopenia / Q000209:etiology
keywords: Counting process approach; pancreatic cancer; platelet count; survival