Poor Prognosis Significance of Pretreatment Thrombocytosis in Patients with Colorectal Cancer: a Meta-Analysis

  • Zhao, Jian-Meng (The First Clinical Medical College of Lanzhou University) ;
  • Wang, Yong-Hong (The First Clinical Medical College of Lanzhou University) ;
  • Yao, Nan (The First Clinical Medical College of Lanzhou University) ;
  • Wei, Kong-Kong (The First Clinical Medical College of Lanzhou University) ;
  • Jiang, Lei (Department of General Surgery, the First Hospital of Lanzhou University) ;
  • Hanif, Shahbaz (The First Clinical Medical College of Lanzhou University) ;
  • Wang, Zi-Xia (The First Clinical Medical College of Lanzhou University)
  • Published : 2016.09.01

Abstract

Background: Recently, several studies have reported that elevated platelet counts may be associated with the poor prognosis of colorectal cancer. However, conclusions remain controversial. This meta-analysis was therefore designed to analyze and evaluate the prognostic role of preoperative or pretreatment thrombocytosis in patients with colorectal cancer. Materials and Methods: We searched PubMed, EMBASE, the Cochrane Library and Web of Science to March 29th, 2015. The citation lists of included studies were also hand-searched to identify further relevant trials. To investigate the association between thrombocytosis and prognosis of colorectal cancer, the 1-year, 3-year and 5-year survival of each studies were obtained. The odds ratio (OR) with its 95% confidence interval (CI) was used to evaluate the relation of overall survival (OS) between thrombocytosis and normal platelet counts (PLT). Likewise, disease free survival (DFS) was obtained and evaluated. The analysis was performed and assessed using Review Manager 5.2. Results: A total of 14 studies (N=5,566 participants, 11 including 4,468 for OS, 6 including 1,533 for DFS) were included in this meta-analysis, of which seven (N=3810) defined thrombocytosis as a platelet count ${\geq}400{\times}10^9/L$, and 375 (9.8%) patients exhibited pretreatment thrombocytosis. Thrombocytosis have a close relationship with the poor OS of colorectal cancer compared with normal PLT, with the pooled ORs of 1-year, 3-year and 5-year survival being 0.41 [95% CI 0.34-0.51; P<0.001], 0.28 [95% CI 0.21-0.38; P<0.001] and 0.26 [95% CI 0.20-0.34; P<0.001], respectively. For DFS, the same results were showed as the pooled ORs of 1-year, 3-year and 5-year survival respectively being 0.34 [95% CI 0.24-0.50; P<0.001], 0.31 [95% CI 0.23-0.43; P<0.001] and 0.25 [95% CI 0.18-0.34; P<0.001]. Conclusions: This meta-analysis indicated that thrombocytosis may predict poor prognosis for patients with colorectal cancer, and platelet counts may be a cost-effective and noninvasive marker.

Keywords

References

  1. Alcindor T, et al (2008). Is the platelet count a pronostic factor in pancreas cancer and cholangiocarcinoma? Ann Oncol, 19, 185.
  2. AlSaeed EF, et al (2015). Correlation of pretreatment hemoglobin and platelet counts with clinicopathological features in colorectal cancer in Saudi Population (vol 20, pg 134, 2014). Saudi J Gastroenterol, 21, 58. https://doi.org/10.4103/1319-3767.151237
  3. Aranda E, Aparicio J, Alonso V, et al (2015). SEOM clinical guidelines for diagnosis and treatment of metastatic colorectal cancer 2015. Clin Transl Oncol, 17, 972-81. https://doi.org/10.1007/s12094-015-1434-4
  4. Baranyai Z, Krzystanek M, Josa V, et al (2014). The comparison of thrombocytosis and platelet-lymphocyte ratio as potential prognostic markers in colorectal cancer. Thromb Haemost, 111, 483-90. https://doi.org/10.1160/TH13-08-0632
  5. Campos Gomez S, et al (2014). Pretreatment platelets count levels as a prognostic factor in triple-negative breast cancer in a Hispanic cohort. J Clin Oncol, 32, 15.
  6. Canadian Cancer Society's Advisory Committee on Cancer Statistics (2013) Canadian Cancer Statistics 2013. http://www.cancer.ca//media/cancer.ca/CW/cancer%20information/cancer%20101/Canadian%20 cancer%20 statistics/canadian-cancer-statistics-2013-EN.pdf. Accessed 10 Sept 2013.
  7. Castillo-Perez JJ. (2013). Regarding the article "thrombocytosis as a predictor of distant recurrence in patients with rectal cancer". Arch Med Res, 44, 77-8. https://doi.org/10.1016/j.arcmed.2012.11.005
  8. Chen W, Zheng R, Zuo T, et al (2016). National cancer incidence and mortality in China, 2012. Chin J Cancer Res, 28, 1-11.
  9. Cravioto-Villanueva A, Luna-Perez P, Gutierrez-de la Barrera M, et al (2012). Thrombocytosis as a Predictor of Distant Recurrence in Patients with Rectal Cancer. Arch Med Res, 43, 305-11. https://doi.org/10.1016/j.arcmed.2012.06.008
  10. Gu ML, Yuan CJ, Liu XML, et al (2015). Pre-treatment Elevated Platelet Count Associates with HER2 Overexpression and Prognosis in Patients with Breast Cancer. Asian Pac J Cancer Prev, 16, 5537-40. https://doi.org/10.7314/APJCP.2015.16.13.5537
  11. Guo T, Krzystanek M, Szallasi Z, Szallasi A (2014). Thrombocytosis portends adverse prognostic significance in patients with stage II colorectal carcinoma. F1000Research, 3, 180.
  12. Higgins J and GS (eds). Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration 2011. www.cochranehandbook. org (18 March 2014, date last accessed).
  13. Ishizuka M, Nagata H, Takagi K, Iwasaki Y, Kubota K (2012). Preoperative thrombocytosis is associated with survival after surgery for colorectal cancer. J Surg Oncol, 106, 887-91. https://doi.org/10.1002/jso.23163
  14. Ishizuka M, Nagata H, Takagi K, Iwasaki Y, Kubota K (2013). Combination of platelet count and neutrophil to lymphocyte ratio is a useful predictor of postoperative survival in patients with colorectal cancer. Br J Cancer, 109, 401-7. https://doi.org/10.1038/bjc.2013.350
  15. Ilhan-Mutlu A, Starlinger P, Perkmann T, et al (2015). Plasma fibrinogen and blood platelet counts are associated with response to neoadjuvant therapy in esophageal cancer. Biomark Med, 9, 327-35. https://doi.org/10.2217/bmm.14.111
  16. Josa V, Krzystanek M, Eklund AC, et al (2015). Relationship of postoperative thrombocytosis and survival of patients with colorectal cancer. Int J Surg, 18, 1-6. https://doi.org/10.1016/j.ijsu.2015.03.005
  17. Josa V, Krzystanek M, Vass T, et al (2015). Thrombocytosis of Liver Metastasis from Colorectal Cancer as Predictive Factor. Pathol Oncol Res, 21, 991-7. https://doi.org/10.1007/s12253-015-9925-8
  18. Kanavos P and Schurer W (2010). The dynamics of colorectal cancer management in 17 countries. Eur J Health Econ, 10, 115-29. https://doi.org/10.1007/s10198-009-0201-2
  19. Kandemir EG, Mayadagli A, Karagoz B, et al (2005). Prognostic significance of thrombocytosis in node-negative colon cancer. J Int Med Res, 33, 228-35. https://doi.org/10.1177/147323000503300211
  20. Kawai K, Kitayama J, Tsuno NH, Sunami E, Watanabe T (2013). Thrombocytosis before pre-operative chemoradiotherapy predicts poor response and shorter local recurrence-free survival in rectal cancer. Int J Colorectal Dis, 28, 527-35. https://doi.org/10.1007/s00384-012-1594-4
  21. Kisucka J, Butterfield CE, Duda DG, et al (2006). Platelets and platelet adhesion support angiogenesis while preventing excessive hemorrhage. Proc Natl Acad Sci U S A, 103, 855-60. https://doi.org/10.1073/pnas.0510412103
  22. Lin MS, Huang JX, Zhu J, Shen HZ. (2012). Elevation of platelet count in patients with colorectal cancer predicts tendency to metastases and poor prognosis. Hepatogastroenterology, 59, 1687-90.
  23. Men H , Liang C, Yu M (2015). Thrombocytosis as a prognostic factor in patients with renal cell carcinoma: a meta-analysis of literature. J Cancer Res Ther, 11, 67-72. https://doi.org/10.4103/0973-1482.150345
  24. Monreal M, Fernandez-Llamazares J, Pinol M, et al (1998). Platelet count and survival in patients with colorectal cancer - a preliminary study. Thromb Haemost, 79, 916-8.
  25. Nieswandt B, Hafner M, Echtenacher B, Mannel DN (1999). Lysis of tumor cells by natural killer cells in mice is impeded by platelets. Cancer Res, 59, 1295-300.
  26. Nyasavajjala SM, Runau F, Datta S, et al (2010). Is there a role for pre-operative thrombocytosis in the management of colorectal cancer? Int J Surg, 8, 436-38. https://doi.org/10.1016/j.ijsu.2010.05.005
  27. Padilla D, Cubo T, Pardo R, et al (2004). Preoperative platelet count and colorectal cancer recurrence. Rev Esp Enferm Dig, 96, 733-4.
  28. Peterson JE, Zurakowski D, Italiano JE Jr, et al (2012). VEGF, PF4 and PDGF are elevated in platelets of colorectal cancer patients. Angiogenesis, 15, 265-73. https://doi.org/10.1007/s10456-012-9259-z
  29. Qiu MZ, Yuan ZY, Luo HY, et al (2010). Impact of pretreatment hematologic profile on survival of colorectal cancer patients. Tumour Biol, 31, 255-60. https://doi.org/10.1007/s13277-010-0024-x
  30. Review Manager (RevMan) [Computer Program]. Version 5.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2012.
  31. Sasaki K, Kawai K, Tsuno NH, Sunami E, Kitayama J (2012). Impact of preoperative thrombocytosis on the survival of patients with primary colorectal cancer. World JnSurg, 36, 192-200. https://doi.org/10.1007/s00268-011-1329-7
  32. Shwaiki A and Safar AM (2004) . The impact of platelet count (Plt#) on outcome in curable colon cancer. World J Surg, 22, 893S.
  33. Suzuki K, Aiura K, Kitagou M, et al (2004). Platelets counts closely correlate with the disease-free survival interval of pancreatic cancer patients. Hepatogastroenterology, 51, 847-53.
  34. Toiyama Y, Inoue Y, Kawamura M, et al (2015). Elevated platelet count as predictor of recurrence in rectal cancer patients undergoing preoperative chemoradiotherapy followed by surgery. Int Surg, 100, 199-207. https://doi.org/10.9738/INTSURG-D-13-00178.1
  35. University of York Centre for Reviews and Dissemination. Systematic Reviews: CRD's Guidance for Undertaking Reviews in Health Care. York: CRD, University of York, 2009.
  36. Wan S, Lai Y, Myers RE, et al (2013). Preoperative platelet count associates with survival and distant metastasis in surgically resected colorectal cancer patients. J Gastrointest Cancer, 44, 293-304. https://doi.org/10.1007/s12029-013-9491-9
  37. Wang C, Chen YG, Gao JL, et al (2015). Low local blood perfusion, high white blood cell and high platelet count are associated with primary tumor growth and lung metastasis in a 4T1 mouse breast cancer metastasis model. Oncol Lett, 10, 754-60. https://doi.org/10.3892/ol.2015.3304
  38. Xin-Ji Z, Yong-Gang L, Xiao-Jun S, et al (2015). The prognostic role of neutrophils to lymphocytes ratio and platelet count in gastric cancer: A meta-analysis. Int J Surg, 21, 84-91. https://doi.org/10.1016/j.ijsu.2015.07.681
  39. Yu I, Chen L, Ruan JY, Chang JT, Cheung WY (2016). Risk and management of venous thromboembolisms in bevacizumabtreated metastatic colorectal cancer patients. Support Care Cancer, 24, 1199-208. https://doi.org/10.1007/s00520-015-2899-y
  40. Yu M, Liu L, Zhang BL, et al (2012). Pretreatment thrombocytosis as a prognostic factor in women with gynecologic malignancies: a meta-analysis. Asian Pac J Cancer Prev, 13, 6077-81. https://doi.org/10.7314/APJCP.2012.13.12.6077
  41. Zhang X and Ran Y (2015). Prognostic role of elevated platelet count in patients with lung cancer: a systematicreview and meta-analysis. Int J Clin Exp Med, 8, 5379-87.