Impact of preoperative thrombocytosis on pathological outcomes and survival in patients treated with radical cystectomy for bladder carcinoma.

Abstract

AIM:

To investigate the impact of preoperative platelet count on pathological findings at the time of Radical Cystectomy for Bladder Cancer and postoperative cancer-specific and overall survival.

PATIENTS AND METHODS:

A total of 906 consecutive patients treated with Radical Cystectomy for Bladder Cancer between 1995 and 2012 at a tertiary referral Center were included in the study. Thrombocytosis was defined as >400,000 platelets/μl, in agreement with the standard assumed by the central laboratory of our Institution. Univariable and multivariable logistic regression analyses were used to investigate the impact of preoperative platelet count on pathological stage. Univariate and multivariate Cox regression analyses were also adopted to predict both cancer-specific and overall survival.

RESULTS:

The mean age at cystectomy was 67.25 years. The mean and median platelet counts were 242,100/μl and 227,500/μl. At a mean follow-up time of 41 months, the 2- and 5-year cancer-specific and overall survival were found to be 83.1% and 75.2% and 68.3 and 59.8%, respectively. At Univariable analysis, thrombocytosis count was significantly associated with adverse pathological disease stage (p ≤ 0.007) and lymph node invasion (p=0.05). Platelet count was significantly associated to patient survival at univariable analysis (Hazard Ratio=1.76 and 1.39 for overall survival and cancer specific survival, respectively; all p<0.05). At multivariate Cox regression analysis, platelet count was documented to be significantly related only to overall survival (Hazard Ratio=64,1.03-2.81; p=0.05).

CONCLUSION:

Preoperative platelet count should be taken into account as a factor predictive of postoperative oncological outcomes after radical cystectomy for bladder cancer and patients should be counseled accordingly.

• Authors: Marco Moschini, Nazareno Suardi, Federico Pellucchi, Lorenzo Rocchini, Giovanni La Croce, Umberto Capitanio, Alberto Briganti, Rocco Damiano, Francesco Montorsi, Renzo Colombo
• Journal: Anticancer research (Anticancer Res) Vol. 34 Issue 6 Pg. 3225-30 (Jun 2014) ISSN: 1791-7530 [Electronic] Greece
• PMID: 24922698 (Publication Type: Journal Article)
• Copyright: Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Topics

• Aged
• Carcinoma, Transitional Cell (mortality, pathology, surgery)
• Cystectomy (mortality)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Muscle Neoplasms (mortality, pathology, surgery)
• Neoplasm Grading
• Neoplasm Invasiveness
• Neoplasm Staging
• Platelet Count
• Preoperative Care
• Prognosis
• Survival Rate
• Thrombocytosis (mortality)
• Urinary Bladder Neoplasms (mortality, pathology, surgery)