Pretreatment thrombocytosis as a significant prognostic factor in malignant mesothelioma: a meta-analysis

Abstract

The current meta-analysis analyzed the prognostic impact of elevated platelet count before the treatment of malignant mesothelioma (MM). We performed a search for articles published up to April 15, 2016 in PubMed, MEDLINE, EMBASE, and Web of Science, which evaluated elevated platelet count and survival outcome of MM. STATA version 12 was used for statistical analysis. The pooled hazard ratios (HRs) and their 95% confidence intervals (CIs) were combined to calculate overall effects. The assessment of heterogeneity was tested by the Cochran Q and I statistics. The sensitivity and meta-regression analyses were performed to explore the origin of heterogeneity. We analyzed 18 eligible studies (3602 patients) that evaluated the correlation between pretreatment platelet count and overall survival (OS). Elevated platelet count was a prognostic factor of poor OS, with a pooled HR of 1.56 (95% CI = 1.36-1.77). However, significant heterogeneity was observed in the included studies (I = 86.0%, p < 0.001). Sensitivity and meta-regression analyses were performed to trace the origin of heterogeneity. Only the variable type (multivariable or univariate model) was traced as the origin of heterogeneity. Hence, we conducted a subgroup analysis of variable type. The HR was 1.66 (95% CI = 1.41-1.91) in the multivariable group and no significant heterogeneity was observed (I = 0.0%, p = 0.476). In conclusion, high pretreatment platelet count resulted in poor OS in MM. Therefore, platelet count could be an adequate and useful factor of prognosis for MM.

Retrospective Evaluation of the Use of Pembrolizumab in Malignant Mesothelioma in a Real-World Australian Population

“…12 In our study, differential blood counts did not predict outcomes from pembrolizumab (Supplementary Tables 4 and 5), with the exception of elevated baseline platelet count (>400 Â 10 9 /liter), which was an independent predictor of lower OS and PFS. This is consistent with previous observations, as platelets are known to release a large number of proangiogenic factors, for example, VEGF, 37 which is an adverse prognostic factor and predicts a worse outcome in MPM. 39 There are scarce data regarding other predictive biomarkers for immunotherapy.…”

“…Markers such as NLR and differential blood counts have exhibited prognostic value in MPM. 14 , 36 , 37 , 38 However, they have not been widely investigated in clinical trials, and it is not known whether they can predict response to immunotherapy. In the phase 2 NivoMes trial, lymphocytes, lactate dehydrogenase, C-reactive protein, and NLR were investigated for their predictive value in addition to PD-L1.…”

High tumor cell platelet‐derived growth factor receptor beta expression is associated with shorter survival in malignant pleural epithelioid mesothelioma

“…The vast majority of our patients, especially in the primary cohort, had the epithelial subtype of MPM, and our results may not be generalizable to other MPM subtypes. Elevated blood platelet count is associated with poor overall survival in MPM [ 50 ]. It is possible that a high blood platelet count indicates higher tumor cell PDGFRB expression.…”

Consensus Guideline for the Management of Patients with Peritoneal Mesothelioma

“…These patients are typically of male sex and at least 75 years old, patient prognostic factors associated with overall worse survival 4, 29, 73, 75, 87, 91 . Preoperative baseline thrombocytosis has been established as a poor prognostic marker associated with decreased overall survival 67, 78, 92 .…”