The negative prognostic implications of thrombocytosis in women with stage IB cervical cancer
Rodriguez, G.C.; Clarke-Pearson, D.L.; Soper, J.T.; Berchuck, A.; Synan, I.; Dodge, R.K.
Obstetrics and Gynecology 83(3): 445-448
1994
ISSN/ISBN: 0029-7844 PMID: 8127540 Document Number: 430532
Objective: To determine the association between pretreatment platelet count and survival in women with stage IB cervical cancer. Methods: Clinical records were reviewed for 219 women with stage IB cervical cancer treated by radical hysterectomy from 1971-1984. Univariate and multivariate analyses were performed to identify clinicopathologic variables associated with poor survival. Survival as a function of the preoperative platelet count was analyzed further and corrected for known prognostic factors. Results: The cumulative 5-year survival of women with a preoperative platelet count greater than 300,000/mu-L (n = 85) was 65%, as compared to 84% for a count equal to or less than 300,000/mu-L (n = 134) (P = .004). Univariate Cox regression analysis revealed non-white race, large lesion size (greater than 4 cm), platelet count greater than 300,000/ mu-L, and the presence of nodal metastases to be factors related to poor prognosis. A comparison of patients with platelet counts of 300,000/mu-L or less and patients with platelet counts greater than 300,000/mu-L revealed no difference with regard to race, nodal metastases, and median age. However, a larger percentage of women with a platelet count greater than 300,000/mu-L had large lesion size (29 of 60, versus 32 of 114 with a count of 300,000/mu-L or less). In a multivariate analysis, after adjusting for age, race, the presence of nodal metastases, and lesion size, high platelet count was still associated with poor prognosis (P = .04). Conclusion: An elevated platelet count is an independent prognostic factor for poor survival in patients with early-stage cervical cancer.