Thrombocytosis predicts poor prognosis of Asian patients with colorectal cancer: A systematic review and meta-analysis

Abstract

Background: There is no study analyzing and evaluating the prognostic role of thrombocytosis in Asian patients with colorectal cancer (CRC).Methods: A systematic search of articles (PubMed, Embase, and the Cochrane Library) was performed to identify studies using the terms Platelet count, Thrombocytosis, Thrombocytoses, Thrombocythemia or Thrombocythemias with colon, colonic, rectal, rectum, colorectal and prognostic, prognosis, survival or outcome.Results: Thirteen eligible studies with 3964 patients were included. Thrombocytosis was associated with a poorer overall survival (HR of 1.88 [95% CI: 1.24-2.85; P = .003] with univariate analyses, HR of 2.07 [95% CI: 1.2-3.56; P = .008] with multivariate analyses), disease-free survival (HR of 2.58 [95% CI: 1.87-3.57; P < .00001] with multivariate analyses) and cancer specific survival (HR of 2.55 [95% CI: 1.68-3.85; P < .00001]) in Asian patients with CRC. Thrombocytosis had a significant association with female gender, tumor location in the colon, higher pathological T-stage, pathological positive N-stage, but not with lymphatic involvement and venous involvement. Conclusion:The present meta-analysis demonstrates that thrombocytosis is a potentially useful tool for predicting poor survival in Asian patients with CRC, especially for overall survival.

Pre-treatment thrombocytosis and ovarian cancer survival: A meta-analysis

“…Several studies have indicated that thrombocytosis increases the risk of recurrence and death in various forms of cancer [41] , [42] , [43] , [44] . The proposed underlying mechanism seems to be primarily related to the onset of a cancer-induced inflammatory cascade that triggers the release of several inflammatory factors which, in turn, promote cancer progression by enhancing malignant conversion, invasion and metastasis [4] .…”

Effectiveness of D-dimer in predicting distant metastasis in colorectal cancer

“…D-dimer and brinogen degradation products (FDP) are protein fragments released into the systemic circulation due to degradation of blood clots. Many coagulation abnormalities, such as thrombocytosis, high brinogenemia, elevated D-dimer levels and FDP, are associated with the progression or poor prognosis of CRC [5][6][7] . In addition, many studies have found that the hypercoagulable state of blood is closely related to the metastasis and development of tumors [8,9] .…”

Marked reactive thrombocytosis in a female with iron deficiency anaemia

“…Thrombocytosis is characterised by an elevated platelet count in the bloodstream and can have various physiological and pathological origins. According to the 2017 criteria by the WHO, thrombocytosis is defined as a platelet count above 450×10 9 /L 1. It can occur as a primary event in haematological diseases or as a secondary event known as reactive thrombocytosis.…”

“…The increased platelet concentration and aggregation can lead to the consumption of von Willebrand factor, increasing the risk of bleeding or thrombosis 1 3. While secondary thrombocytosis is generally benign, in the presence of iron deficiency, it can pose a risk of arterial and venous thrombosis 5…”