title: The prognostic value of pretreatment platelet count in patients with head and neck squamous cell carcinoma.
abstract: OBJECTIVE
  Thrombocytosis is commonly observed in patients with solid tumors. This study aimed to evaluate the prognostic role of circulating pretreatment platelet count in a large series of patients with head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  We retrospectively studied 824 patients with HNSCC treated at a single institution from 2000 to 2012. Disease-specific survival and local, regional, and distant recurrence-free survival were analyzed according to the distribution of the platelet count.
  
  
  RESULTS
  By defining the platelet count 250.05×109/L as a cut-off point with the best predictive capacity, we classified the patients into two groups: those with a high platelet count (n=378, 45.9%), and those with a low platelet count (n=446, 54.1%). On univariate analysis, there were significant differences in disease-specific survival depending on pretreatment platelet count (P=0.001). The 5-year specific survival rates were 74.1% (CI 95%: 69.8-78.4%) and 61.6% (CI 95%: 56.4-66.8%) for patients with a low and high platelet count, respectively. According to the results of a multivariate analysis, patients with a high count of platelets had a tendency to a lower disease-specific survival, but the hazard ratio did not reach statistically significant differences (HR 1.24, CI 95%: 0.97-1.61, P=0.085).
  
  
  CONCLUSIONS
  Platelet count was significantly associated with survival in univariate analysis. However, in a multivariate analysis it lost its prognostic capacity, limiting its utility as a prognostic marker in patients with HNSCC. Considering separately each primary tumor location, patients with hypopharyngeal cancer and a high platelet count had a significant decrease of disease-specific survival.
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: lpardo@santpau.cat.
authors.forename: Laura
authors.initials: L
authors.lastname: Pardo
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Valero
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: López
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Jacinto
authors.initials: J
authors.lastname: García
authors.affiliation: Laboratory of Angiology, Vascular Biology and Inflammation, Institute of Biomedical Research (IIB Sant Pau), Barcelona, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Camacho
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Quer
authors.affiliation: Otorhinolaryngology Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: León
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D006801:Humans; D007822:Laryngeal Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D013517:Otorhinolaryngologic Surgical Procedures; D010610:Pharyngeal Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D010976:Platelet Count; D011379:Prognosis; D016016:Proportional Hazards Models; D011878:Radiotherapy; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate; D013922:Thrombocytosis / Q000097:blood* / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents
keywords: Head and neck squamous cell carcinoma; Platelets; Prognostic value; Thrombocytosis