Increased Platelet Counts after Transthoracic En Bloc Resection for Esophageal Cancer is Associated with Significantly Improved Survival

Ling, Frederike C.; Vallböhmer, Daniel; Hoelscher, Arnulf H.; Schmidt, Daniel; Bollschweiler, Elfriede; Schneider, Paul M.

doi:10.1007/s00268-010-0707-x

Cited by 6 publications

(3 citation statements)

References 26 publications

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“…Consequences of thrombocytopenia, other than hemorrhage, are the delay and reduction of chemo- or radiotherapy to avoid a further decrease in platelet counts ( 41 ). Ling et al could show that an increase of platelets after the resection of esophagus carcinoma is associated with improved survival ( 42 ). In contrast, thrombocytosis in other malignant diseases correlated with poorer prognosis for recurrence-free and overall survival (OS) in several studies ( 5 , 43 ).…”

Section: Discussionmentioning

confidence: 99%

Long-term changes in blood counts after intraoperative radiotherapy for breast cancer—single center experience and review of the literature

Wersal

Keller

Weiß

et al. 2019

Transl. Cancer Res.

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Background: Intraoperative radiotherapy (IORT) for breast cancer is used as an upfront boost or as accelerated partial breast irradiation (APBI). To date, no description of blood count changes after IORT are available. Our analysis shows blood count changes in breast cancer patients up to 5 years after IORT ± whole breast radiotherapy (WBRT).Methods: IORT was given as APBI in 58 patients (IORT/APBI-group) and as a boost in 198 patients (IORT/WBRT-group). A median dose of 20 Gy was given intraoperatively with low energy X-rays [INTRABEAM (TM) System] and additionally 46 Gy/2 Gy per fraction to the whole breast, if WBRT was added. Blood counts were collected preoperatively, after 90 days and through year 1-5 of followup. Dunnett's tests were used to calculate changes in blood counts over time. Additionally, platelet-tolymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and derived neutrophil-to-lymphocyte ratio (dNLR) were calculated for each time point.Results: Significantly decreases in the IORT/WBRT-group were seen for erythrocytes, hemoglobin, platelets and leucocytes and an increase for lymphocytes for the total follow-up period. In the IORT/APBIgroup significantly decreases were seen for erythrocytes and hemoglobin for the total follow-up period.Regarding changes during follow-up compared to the preoperative value, much more significant changes were seen in the IORT/WBRT-group compared to IORT/APBI-group without any relevant impact of chemotherapy. Regarding PLR-, NLR-and dNLR-values the rate of patients over the range improved over time in both groups.Conclusions: IORT/APBI seems to have a smaller effect on blood counts compared to IORT/WBRT. Furthermore, PLR-, NLR-and dNLR-values improved over time, suggesting a positive effect on outcome after IORT in general.

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Section: Discussionmentioning

confidence: 99%

Long-term changes in blood counts after intraoperative radiotherapy for breast cancer—single center experience and review of the literature

Wersal

Keller

Weiß

et al. 2019

Transl. Cancer Res.

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“…In esophageal cancer (SCC and AC), an increase in platelet count after en bloc resection has been reported to be associated with better prognosis in one study [19], and in a study from Pakistan, low preoperative platelet counts were associated with poor prognosis [20]. In contrast, another study found that preoperative thrombocytosis indicated poor prognosis in esophageal SCC [20].…”

Section: Discussionmentioning

confidence: 98%

Thrombocytes Correlate with Lymphangiogenesis in Human Esophageal Cancer and Mediate Growth of Lymphatic Endothelial Cells In Vitro

et al. 2013

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Recent data provide evidence for an important role of thrombocytes in lymphangiogenesis within human malignant disease. The aim of this study was to investigate the role of thrombocytes in lymphangiogenesis in human esophageal cancer. Perioperative peripheral blood platelet counts (PBPC) were evaluated retrospectively in 320 patients with esophageal cancer, comprising 184 adenocarcinomas (AC), and 136 squamous cell carcinomas (SCC). Data on lymphangiogenesis evaluated by anti-podoplanin immunostaining were available from previous studies, platelets within the tumor tissue were assessed by CD61 immunostaining. For in vitro studies, human lymphatic endothelial cells (LECs) were isolated and co-cultured with peripheral blood platelets. Stromal thrombocytic clusters (STC) were evident in 82 samples (25.6%), and vascular thrombocytic clusters (VTC) in 56 (17.5%). STC and VTC were associated with a significantly higher PBPC at investigation of all cases. The presence of STC was associated with higher lymphatic microvessel density (p<0.001), PBPC and STC were associated with lymphovascular invasion of tumor cells in a regression model. The presence of STCs was associated with shorter DFS of all patients (p = 0.036, Breslow test), and VTC with shorter DFS in in SCC (p = 0.025, Breslow test). In cell culture, LEC proliferation was enhanced by co-culture with human platelets in a dose- and time-dependent manner mediated by the release of PDGF-BB and VEGF-C. Platelets play an important role in lymphangiogenesis and lymphovascular invasion in esophageal cancer, influencing prognosis. So the disruption of signaling pathways between platelets, tumor cells and lymphatic endothelium might be of benefit for patients.

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“…This discordance may lead to between-study heterogeneity and affect the significance of results ( 16 ). For example, Shimada ( 27 ) and Ling ( 28 ) defined thrombocytosis as platelet count over 293×10 9 /L in esophagus tumor. They found thrombocytosis appeared in approximately 20% patients, whereas Aminian ( 29 ) and Dutta ( 30 ) reported a 3.4–4.46% incidence based on the 400×10 9 /L cutoff.…”

Section: Correlation Between Increased Platelet Counts and Cancer Prognosismentioning

confidence: 99%

Bidirectional Interaction Between Cancer Cells and Platelets Provides Potential Strategies for Cancer Therapies

Guo

Chang

et al. 2021

Front. Oncol.

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Platelets are essential components in the tumor microenvironment. For decades, clinical data have demonstrated that cancer patients have a high risk of thrombosis that is associated with adverse prognosis and decreased survival, indicating the involvement of platelets in cancer progression. Increasing evidence confirms that cancer cells are able to induce production and activation of platelets. Once activated, platelets serve as allies of cancer cells in tumor growth and metastasis. They can protect circulating tumor cells (CTCs) against the immune system and detachment-induced apoptosis while facilitating angiogenesis and tumor cell adhesion and invasion. Therefore, antiplatelet agents and platelet-based therapies should be developed for cancer treatment. Here, we discuss the mechanisms underlying the bidirectional cancer-platelet crosstalk and platelet-based therapeutic approaches.

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Increased Platelet Counts after Transthoracic En Bloc Resection for Esophageal Cancer is Associated with Significantly Improved Survival

Cited by 6 publications

References 26 publications

Long-term changes in blood counts after intraoperative radiotherapy for breast cancer—single center experience and review of the literature

Long-term changes in blood counts after intraoperative radiotherapy for breast cancer—single center experience and review of the literature

Thrombocytes Correlate with Lymphangiogenesis in Human Esophageal Cancer and Mediate Growth of Lymphatic Endothelial Cells In Vitro

Bidirectional Interaction Between Cancer Cells and Platelets Provides Potential Strategies for Cancer Therapies

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