Investig Clin Urol.  2016 Sep;57(5):324-329. 10.4111/icu.2016.57.5.324.

Clinical significance of preoperative thrombocytosis in patients who underwent radical nephrectomy for nonmetastatic renal cell carcinoma

• Choi JY
• Ko YH
• Song PH

• KMID: 2427010
• DOI: http://doi.org/10.4111/icu.2016.57.5.324

Abstract

PURPOSE
The aim of this study was to examine the association of preoperative thrombocytosis with the prognosis of patients with nonmetastatic renal cell carcinoma (RCC).
MATERIALS AND METHODS
We conducted a retrospective analysis of 187 patients who underwent a radical nephrectomy for nonmetastatic RCC between July 1997 and June 2009. Thrombocytosis was defined as a platelet count≥400,000 µL, and patients were divided into 2 groups according to presence of preoperative thrombocytosis, and the cancer-specific survival rates and overall survival rates of the 2 groups after radical nephrectomy were compared.
RESULTS
The mean age of the patients was 56.0±11.7 years and the mean follow-up period was 59.3±42.1 months; there were 20 patients with preoperative thrombocytosis. Thirty patients developed metastases and 9 patients died during the follow-up period. In Kaplan-Meier analysis using a univariate log-rank test, both cancer-specific survival rate (p=0.013) and overall survival rate (p=0.012) showed significant association with preoperative thrombocytosis. Controlling for pathological TNM stage, Fuhrman grade and tumor diameter, the Cox proportional hazards model for cancer-specific survival rates showed that preoperative thrombocytosis was an independent prognostic factor (p=0.025).
CONCLUSIONS
Preoperative thrombocytosis was associated with poorer prognosis in patients with nonmetastatic RCC. Thus, preoperative platelet count may be clinically useful for risk stratification of patients undergoing surgery for nonmetastatic RCC.

Keyword

Prognosis; Renal cell carcinoma; Thrombocytosis

MeSH Terms

Adult
Aged
Carcinoma, Renal Cell/classification/pathology/*surgery
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Kidney Neoplasms/complications/pathology/*surgery
Male
Middle Aged
Neoplasm Grading
Neoplasm Staging
Nephrectomy/*methods
Platelet Count
Prognosis
Retrospective Studies
Risk Assessment/methods
Thrombocytosis/blood/*etiology

Figure

• 

  Fig. 1 Kaplan-Meier cancer–specific survival curves (A) and overall survival curves (B) based on preoperative platelet level. The cancer-specific and overall survival rate of patients with preoperative thrombocytosis (platelet count [PLT]≥400,000 µL) were significantly lower than that of patients without thrombocytosis (p=0.013, p=0.012, respectively).

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