Pretreatment platelet count as a predictor for survival and distant metastasis in nasopharyngeal carcinoma patients

Abstract

Abstract. The aim of the present study was to investigate the prognostic value of different pretreatment platelet (PLT) counts on the treatment outcome in nasopharyngeal carcinoma (NPC) patients receiving concurrent chemoradiotherapy (CCRT) or radiotherapy (RT) alone. A total of 1,501 NPC patients, including 412 receiving CCRT and 1,089 receiving RT, were enrolled in the present study. The PLT count cut-off points for the CCRT and RT groups were 150 and 300x10 9 /l, respectively, and the PLT counts were categorized it into three groups: Low (PLT≤150x10 9 /l), moderate (150x10 9 /l<PLT≤300x10 9 /l) and high (PLT>300x10 9 /l). To identify independent predictors of overall survival (OS), the Cox proportional hazards model was used to determine local-regional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) rates in the CCRT and RT patients. Furthermore, univariate and multivariate analysis indicated that compared with a moderate PLT count, a low PLT count was an independent unfavorable prognostic factor for OS rate in CCRT patients [hazard ratio (HR), 2.024; 95% confidence interval (CI), 1.165-3.516], and a high PLT count was an independent unfavorable prognostic factor for OS and DMFS rates in CCRT (OS: HR, 1.742; 95% CI, 1.090-2.786; DFMS: HR, 2.110; 95%CI, 1.084-4.108) and RT (OS: HR, 1.740; 95%CI, 1.283-2.362; DMFS: HR, 2.819; 95% CI, 1.766-4.497) patients. Compared with a low PLT count, a high PLT count was significantly and independently associated with a poor DMFS rate in the RT patients (P=0.025; HR, 2.454; 95% CI, 1.121-5.372). Therefore, the present study indicates that low and high PLT counts may be useful indicators of survival and distant metastasis in NPC patients who have undergone radiation treatment.

Pretreatment hematologic markers as prognostic factors in patients with nasopharyngeal carcinoma

“…Most studies reported that patients with high platelet counts showed poor prognosis. However, it is worth noting that Chen et al [24] found that patients those with lowest platelet counts (<150 × 10 9 ) also demonstrated poor OS; additionally, the OS of patients with highest platelet counts (>300 × 10 9 ) was not significantly lower than those with lowest platelet counts (<150 × 10 9 ). These inconsistent results across studies suggest that patients with a very low platelet count may also have a poor prognosis.…”

“…Four studies focused on metastatic NPC, [21,22,23,27] whereas 10 studies only included patients with nonmetastatic NPC. [16–20,24–26,28,29] The majority of studies assessed the patients’ hematologic parameters before treatment. NLR and lymphocyte counts were the most reported hematologic parameters, followed by PLR and LMR.…”

“…One study [18] evaluated the effect of platelet counts during treatment on survival, whereas 3 other studies [19,24,26] evaluated that of the pretreatment platelet count. Most studies reported that patients with high platelet counts showed poor prognosis.…”

“…In this meta-analysis, we found only 3 studies examined here evaluated the prognosis value of platelet counts: Du et al, [26] Gao et al, [19] and Chang et al [18] reported that thrombocytosis was associated with poor survival outcome in patients with NPC. Differently, the study conducted by Chen et al [24] stated that low and high platelet counts may predict poor survival and distant metastasis in NPC. The contradicting conclusions among these studies revealed that the prognostic value of platelet counts in NPC requires further study and that there may be a potential “J-shape” correlation between platelet count and surviving HR.…”

Prognostic value of pretreatment peripheral blood markers in paranasal sinus cancer: Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio

“…6,7 The neutrophil-tolymphocyte ratio (NLR) 5,[8][9][10][11] and the platelet-tolymphocyte ratio (PLR) 6,12,13 are biomarkers reflecting systemic inflammation that can be easily and inexpensively measured from a peripheral blood sample. 6,7 The neutrophil-tolymphocyte ratio (NLR) 5,[8][9][10][11] and the platelet-tolymphocyte ratio (PLR) 6,12,13 are biomarkers reflecting systemic inflammation that can be easily and inexpensively measured from a peripheral blood sample.…”