title: Prognostic relevance of hematological profile before resection for colorectal liver metastases.
abstract: Although alterations of hematological profile and especially elevated platelet counts were reported to influence survival in primary colorectal cancer, its prognostic relevance before the surgical treatment of colorectal liver metastases (CLM) is mainly unclear. Therefore, the aim of this study was to analyze the impact of these factors on overall survival following liver resection of CLM.
  
  
  
  The surgical treatment of primary CLM between 1994 and 2012 in 983 patients was retrospectively analyzed using univariable and multivariable Cox regression models.
  
  
  
  In the multivariable analyses, a preoperative anemia was independently associated with inferior overall outcome (P = 0.005, hazard ratio: 1.355). However, with only 2.7% of all cases, an elevation of preoperative platelets was not a frequent finding and no independent impact on survival (P = 0.834). Furthermore, abnormal hemoglobin and platelet values had no impact on rate of surgical revisions due to bleeding complications (P = 0.962 and P = 0.671, respectively), but a potential interaction between abnormal hemoglobin and platelet values and the amount of transfused packed red blood cells (P = 0.004 and P < 0.001, respectively) was observed.
  
  
  
  Preoperative anemia is statistically significantly associated with inferior overall survival following resection of CLM and might define a new prognostic marker. Preoperative elevated platelets were not a frequent finding and showed no influence on overall survival.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Hannover, Germany. Electronic address: kulik.ulf@mh-hannover.de.
authors.forename: Ulf
authors.initials: U
authors.lastname: Kulik
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Hannover, Germany; Core Facility Quality Management and Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Schrem
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Hueseyin
authors.initials: H
authors.lastname: Bektas
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Juergen
authors.initials: J
authors.lastname: Klempnauer
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Lehner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D001792:Blood Platelets / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D057234:Preoperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013922:Thrombocytosis / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006454:Hemoglobins
keywords: Colorectal liver metastases; Mortality; Multivariable regression; Risk factors for survival; Risk-adjusted analysis