Kinetics of postdiagnosis platelet count with overall survival of pancreatic cancer: a counting process approach

Xiao, Yuanyuan; Xie, Hua; Shao, Zhiyong; Chen, Wen; Qin, Guoyou; Zhao, Na

doi:10.1002/cam4.644

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…A detailed description of this method can be found in Anderson and Gill’s work [17], and the analytical strategy of AG model in this study is provided in Appendix 1. Although time-dependent variables are ubiquitous in the field of cancer survival, the application of AG model is rare, only can be found in two previously published studies [18, 19].…”

Section: Methodsmentioning

confidence: 99%

Dynamic serum alkaline phosphatase is an indicator of overall survival in pancreatic cancer

et al. 2019

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Background The prognostic role of serum alkaline phosphatase (ALP) has been found in several kinds of solid malignant tumor, but has never been extensively discussed in pancreatic cancer, especially through the application of dynamic survival model which incorporates the varying nature of ALP measurements. Methods We conducted a retrospective study which successfully collected 551 histopathologically confirmed pancreatic ductal adenocarcinoma (PDAC) patients from a cancer specialized hospital in southwest China. The association between variant ALP which measured during the whole survival period and the overall survival (OS) of PDAC patients was evaluated by using dynamic Anderson-Gill (AG) model. Exhaustive sensitivity analysis was performed by adopting continuous cut-offs of ALP. Results After adjusted for possible confounding of serum albumin, total bilirubin and leukocyte counts, AG model revealed that, serum ALP during the survival period was nonlinearly associated with the OS of PDAC: for resected patients, compared with those whose ALP results ranged within the first quartile (

P 75 ) quartiles were observed 1.14 (95% CI: 0.29–4.56), 3.93 (95% CI: 1.23–12.60), 3.87 (95% CI: 1.32–11.36) folds of death hazard; whereas in un-resected PDAC patients, the hazard ratios (HRs) were 1.15 (95% CI: 0.79–1.68), 1.92 (95% CI: 1.32–2.78), and 1.97 (95% CI: 1.30–2.98), respectively. Sensitivity analysis revealed that, for both resected and un-resected patients, the results of AG model were robust with regard to various cut-offs of ALP, and an increased ALP was in general associated with significantly increased hazard of death. Conclusion Serum ALP during the survival period was significantly associated with the OS of PDAC patients, especially for resected early stage PDAC patients. Future studies with expanded sample size and refined prospective design should be implemented to corroborate our major findings. Besides, the underlying mechanism for this possible hazardous role of ALP should also be investigated.

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Section: Methodsmentioning

confidence: 99%

Dynamic serum alkaline phosphatase is an indicator of overall survival in pancreatic cancer

et al. 2019

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“…5 However, the association between platelets and prognosis remains controversial. It was once believed that platelets in the blood circulation (ie, platelet count, platelet CRP multiplier value, plateletto-monocyte ratio and the platelet-to-albumin ratio) are related to poor clinical outcomes in patients with cancer, [6][7][8][9] but evidence also exists suggesting that the platelet count in the blood circulation does not correlate with prognosis. 10 In recent years, researchers have focused on immune cell infiltration and patient survival and have used the immune score to investigate the survival of patients with cancer.…”

Section: Introductionmentioning

confidence: 99%

Platelet infiltration predicts survival in postsurgical colorectal cancer patients

Miao

Feng

et al. 2021

Intl Journal of Cancer

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Platelets promote tumor growth and metastasis in several tumor types. Recent research has found platelets can extravasate and infiltrate into the tumor stroma and interact with the tumor microenvironment. The prognostic role of platelet infiltration in colorectal cancer (CRC) remains controversial. A pancancer survival analysis was performed to find the potential prognostic value of platelet infiltration in patients with cancer. A survival analysis and a nomogram prognostic model were established to further confirm the results with data from our center. The correlations between patient outcomes and tumor-infiltrating platelets (TIPs) were identified by immunohistochemical staining for CD42b. The prognostic accuracy and discriminative ability of the nomogram were determined by the concordance index (C-index) and a calibration curve. The pancancer survival analysis showed platelet infiltration can lead to a poor prognosis in patients with several types of cancers, including CRC. Platelet infiltration was associated with overall survival (OS) and disease-free survival (DFS) in both primary and validation cohorts. The C-index values of the nomogram for predicting OS and DFS were 0.774 and 0.769, respectively, which were higher than that of the TNM staging system alone. Our study found platelet infiltration has a potential prognostic value regarding postsurgical survival in CRC patients. The proposed nomogram resulted in a more accurate prognostic prediction for postsurgical CRC patients.

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“…We only identified 2 newly published studies which discussed this association in advanced PC patients: one observed prominent association while the other did not. [ 15 , 17 ] However, these 2 studies all focused on general OS rather than short-term OS. From this point of view, our study is valuable in accumulating the initial evidence.…”

Section: Discussionmentioning

confidence: 99%

“…[ 26 ] Our finding perhaps suggested that, for advanced PDAC patients, correcting elevated platelet count may bring about short-term survival benefit. However, as we recently found that thrombocytopenia can also cause deteriorated OS of PC, [ 17 ] the correction of thrombocytosis should be dealt with caution in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…This database has been thoroughly described in a previously published study. [ 17 ] We chose advanced PC patients, who were diagnosed between January 1, 2012 and December 31, 2013, from this database, the full-set of inclusion criteria include: histological confirmation of pancreatic ductal adenocarcinoma (PDAC); locally advanced or metastasis occurred, did not receive curative operation; not end-stage PC, defined as survival length after diagnosis exceeded 30 days; blood indicators for calculating inflammatory-based scores were tested within 20 days after histological confirmation; other vital information for analysis was complete, such as age, gender, and palliative chemotherapy agents. In the end, we successfully gleaned 66 advanced PDAC patients for further analysis.…”

Section: Methodsmentioning

confidence: 99%

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Prognostic value of postdiagnostic inflammation-based scores in short-term overall survival of advanced pancreatic ductal adenocarcinoma patients

Xiao¹,

Shao

Chen

et al. 2017

Medicine

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The prognostic relevance of commonly used composite inflammation-based scores remains severely underdiscussed in pancreatic cancer (PC), especially for advanced PC. In this retrospective cohort study, we aimed to discuss the association between multiple inflammatory scores and the short-term overall survival (OS) of advanced pancreatic ductal adenocarcinoma (PDAC) patients. A total of 66 histologically confirmed PDAC patients were retrospectively analyzed. A multivariate Cox proportional hazards model was used to explore the association between 6 commonly used inflammatory scores measured right after diagnosis, Glasgow Prognostic Score (GPS), Modified Glasgow Prognostic Score (mGPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), prognostic index (PI), prognostic nutritional index (PNI), and the short-term OS of advanced PDAC. Analytical results revealed that among GPS, mGPS, NLR, PLR, PI and PNI only PLR was significantly associated with short-term OS of PDAC. For both 1-year and 2-year OS, every 10 increase of PLR value resulted in 1.10 (95% CI: 1.04, 1.16) folds hazard ratio (HR). Further analysis identified a statistically significant dose–response relationship between PLR and HR. Our study results probably suggested that PLR is a promising prognostic factor of advanced PDAC; maintaining normally ranged platelet count may gain short-term survival benefit among such patients.

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Kinetics of postdiagnosis platelet count with overall survival of pancreatic cancer: a counting process approach

Cited by 9 publications

References 19 publications

Dynamic serum alkaline phosphatase is an indicator of overall survival in pancreatic cancer

Dynamic serum alkaline phosphatase is an indicator of overall survival in pancreatic cancer

Platelet infiltration predicts survival in postsurgical colorectal cancer patients

Prognostic value of postdiagnostic inflammation-based scores in short-term overall survival of advanced pancreatic ductal adenocarcinoma patients

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