[Association of preoperative platelet count with the prognosis of patients with colorectal cancer].
OBJECTIVE
To explore the association between preoperative platelet count and the outcomes of patients with colorectal cancer (CRC).


METHODS
This study was conducted among a cohort of 486 CRC patients, who underwent surgery in Sichuan Provincial Cancer Hospital between January, 2010 and July, 2013 and were prospectively followed up for their outcomes. The association between preoperative platelet counts and clinicopathologic factors of the patients were analyzed. Survival analysis of the patients was performed using log-rank test, and the factors affecting the patients' outcomes were analyzed by univariate and multivariate analyses using the Cox proportional hazard model.


RESULTS
In this cohort, preoperative platelet count was significantly associated with the tumor site, depth of tumor invasion (T), and distant metastasis (M) (all P<0.05). Log-rank tests showed that in patients with CRC and rectal cancer, the overall postoperative survival differed significantly between high and low preoperative platelet count groups (Χ(2)=8.813, P=0.003 and Χ(2)=5.110, P=0.024, respectively), but this difference was not observed in patients with colon cancer (P<0.05). Multivariate analysis indicated that CRC patients with a high preoperative platelet count had a higher risk of death compared to those with a low platelet level after adjustment for tumor site, tumor grade, TNM stage, vascular invasion, perineural invasion, and preoperative CEA level (RR=1.814, 95%CI: 1.056-3.115). In subgroup analysis, preoperative platelet count was identified as an independent prognostic factor in patients with rectal cancer (RR=2.718, 95% CI: 1.132-6.526), but not in patients with colon cancer (RR=1.396, 95%CI: 0.705-2.765).


CONCLUSIONS
As an independent prognostic factor in CRC patients, preoperative platelet count may serve as an important indicator for predicting the outcomes of rectal cancer, but its prognostic value for colon cancer needs further clarification.
Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu 610041, China. E-mail: lilingchen2016@163.com.
Li-Ling
LL
Chen
Li
L
Zhang
Yue-Ling
YL
Li
Xiao-Ling
XL
Li
Wen-Hui
WH
Liu
Jin
J
Yan
Yan-Fang
YF
Yang
D003110:Colonic Neoplasms / Q000175:diagnosis; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D006801:Humans; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010976:Platelet Count; D057234:Preoperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D016019:Survival Analysis