The prognostic value of pretreatment platelet count in patients with head and neck squamous cell carcinoma

Auris Nasus Larynx. 2017 Jun;44(3):313-318. doi: 10.1016/j.anl.2016.06.009. Epub 2016 Jul 9.

Abstract

Objective: Thrombocytosis is commonly observed in patients with solid tumors. This study aimed to evaluate the prognostic role of circulating pretreatment platelet count in a large series of patients with head and neck squamous cell carcinoma (HNSCC).

Methods: We retrospectively studied 824 patients with HNSCC treated at a single institution from 2000 to 2012. Disease-specific survival and local, regional, and distant recurrence-free survival were analyzed according to the distribution of the platelet count.

Results: By defining the platelet count 250.05×109/L as a cut-off point with the best predictive capacity, we classified the patients into two groups: those with a high platelet count (n=378, 45.9%), and those with a low platelet count (n=446, 54.1%). On univariate analysis, there were significant differences in disease-specific survival depending on pretreatment platelet count (P=0.001). The 5-year specific survival rates were 74.1% (CI 95%: 69.8-78.4%) and 61.6% (CI 95%: 56.4-66.8%) for patients with a low and high platelet count, respectively. According to the results of a multivariate analysis, patients with a high count of platelets had a tendency to a lower disease-specific survival, but the hazard ratio did not reach statistically significant differences (HR 1.24, CI 95%: 0.97-1.61, P=0.085).

Conclusion: Platelet count was significantly associated with survival in univariate analysis. However, in a multivariate analysis it lost its prognostic capacity, limiting its utility as a prognostic marker in patients with HNSCC. Considering separately each primary tumor location, patients with hypopharyngeal cancer and a high platelet count had a significant decrease of disease-specific survival.

Keywords: Head and neck squamous cell carcinoma; Platelets; Prognostic value; Thrombocytosis.

MeSH terms

  • Aged
  • Antineoplastic Agents / therapeutic use
  • Carcinoma, Squamous Cell / blood*
  • Carcinoma, Squamous Cell / epidemiology
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy
  • Comorbidity
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / blood*
  • Head and Neck Neoplasms / epidemiology
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy
  • Humans
  • Laryngeal Neoplasms / blood*
  • Laryngeal Neoplasms / epidemiology
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / therapy
  • Male
  • Middle Aged
  • Mouth Neoplasms / blood*
  • Mouth Neoplasms / epidemiology
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / therapy
  • Multivariate Analysis
  • Neoplasm Grading
  • Neoplasm Staging
  • Otorhinolaryngologic Surgical Procedures
  • Pharyngeal Neoplasms / blood*
  • Pharyngeal Neoplasms / epidemiology
  • Pharyngeal Neoplasms / pathology
  • Pharyngeal Neoplasms / therapy
  • Platelet Count
  • Prognosis
  • Proportional Hazards Models
  • Radiotherapy
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Rate
  • Thrombocytosis / blood*
  • Thrombocytosis / epidemiology

Substances

  • Antineoplastic Agents