Limits...
Pretreatment platelet count improves the prognostic performance of the TNM staging system and aids in planning therapeutic regimens for nasopharyngeal carcinoma: a single-institutional study of 2,626 patients

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Thrombocytosis has been identified as an unfavorable prognostic factor in several types of cancer. This study aimed to evaluate the prognostic value of pretreatment platelet count in association with the TNM staging system and therapeutic regimens in patients with nasopharyngeal carcinoma (NPC).

Methods: A total of 2,626 patients with NPC were retrospectively analyzed. Platelet count >300 × 109/L was defined as thrombocytosis. Matched-pair analysis was performed between patients receiving chemoradiotherapy and radiotherapy.

Results: Multivariate analysis showed that platelet count was an independent unfavorable prognostic factor for overall survival (OS) [hazard ratio (HR) = 1.810, 95% confidence interval (CI) = 1.531–2.140, P < 0.001] and distant metastasis–free survival (DMFS) (HR = 1.873, 95% CI = 1.475–2.379, P < 0.001) in the entire patient cohort. Further subgroup analysis revealed that increased platelet count was an independent unfavorable prognostic factor for OS and DMFS in patients with NPC stratified by early and advanced T category, N category, or TNM classification (all P ≤ 0.001). Receiver operating characteristic (ROC) curves verified that the predictive value of TNM classification for OS was improved when combined with pretreatment platelet count (P = 0.030). Matched-pair analysis showed that chemoradiotherapy significantly improved OS only in advanced-stage NPC with thrombocytosis (HR = 0.416, 95% CI = 0.226–0.765, P = 0.005).

Conclusions: Pretreatment platelet count, when combined with TNM classification, is a useful indicator for metastasis and survival in patients with NPC. It may improve the predictive value of the TNM classification and help to identify patients likely to benefit from more aggressive therapeutic regimens.

No MeSH data available.


Related in: MedlinePlus

Receiver operating characteristic (ROC) curves for survival prediction with TNM classification alone (stages I–II and III–IV) or with the addition of pretreatment platelet count ( ≤300 × 109/L and >300 × 109/L) to TNM classification in the 2,626 patients with nasopharyngeal carcinoma. A, overall survival. B, locoregional recurrence–free survival. C, distant metastasis–free survival. The P value was the comparison of area under the curves (AUCs) between the addition of platelet count to TNM classification and TNM classification alone.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4593390&req=5

Fig3: Receiver operating characteristic (ROC) curves for survival prediction with TNM classification alone (stages I–II and III–IV) or with the addition of pretreatment platelet count ( ≤300 × 109/L and >300 × 109/L) to TNM classification in the 2,626 patients with nasopharyngeal carcinoma. A, overall survival. B, locoregional recurrence–free survival. C, distant metastasis–free survival. The P value was the comparison of area under the curves (AUCs) between the addition of platelet count to TNM classification and TNM classification alone.

Mentions: ROC curves were used to compare the validity of adding pretreatment platelet count (≤300 × 109/L and >300 × 109/L) to TNM classification (stages I–II and III–IV) for prognostic prediction. For OS, the AUC was 0.58 for TNM classification alone and 0.61when platelet count was added to TNM classification (P = 0.030) (Figure 3A). The results revealed that the addition of platelet count to TNM classification was superior to TNM classification alone in predicting survival for patients with NPC. No significant improvement in predicting locoregional recurrence was observed with the addition of platelet count to TNM classification (P = 0.393) (Figure 3B). For DMFS, adding platelet count to TNM classification had a tendency to improve prediction of distant metastasis (P = 0.086) (Figure 3C).Figure 3


Pretreatment platelet count improves the prognostic performance of the TNM staging system and aids in planning therapeutic regimens for nasopharyngeal carcinoma: a single-institutional study of 2,626 patients
Receiver operating characteristic (ROC) curves for survival prediction with TNM classification alone (stages I–II and III–IV) or with the addition of pretreatment platelet count ( ≤300 × 109/L and >300 × 109/L) to TNM classification in the 2,626 patients with nasopharyngeal carcinoma. A, overall survival. B, locoregional recurrence–free survival. C, distant metastasis–free survival. The P value was the comparison of area under the curves (AUCs) between the addition of platelet count to TNM classification and TNM classification alone.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4593390&req=5

Fig3: Receiver operating characteristic (ROC) curves for survival prediction with TNM classification alone (stages I–II and III–IV) or with the addition of pretreatment platelet count ( ≤300 × 109/L and >300 × 109/L) to TNM classification in the 2,626 patients with nasopharyngeal carcinoma. A, overall survival. B, locoregional recurrence–free survival. C, distant metastasis–free survival. The P value was the comparison of area under the curves (AUCs) between the addition of platelet count to TNM classification and TNM classification alone.
Mentions: ROC curves were used to compare the validity of adding pretreatment platelet count (≤300 × 109/L and >300 × 109/L) to TNM classification (stages I–II and III–IV) for prognostic prediction. For OS, the AUC was 0.58 for TNM classification alone and 0.61when platelet count was added to TNM classification (P = 0.030) (Figure 3A). The results revealed that the addition of platelet count to TNM classification was superior to TNM classification alone in predicting survival for patients with NPC. No significant improvement in predicting locoregional recurrence was observed with the addition of platelet count to TNM classification (P = 0.393) (Figure 3B). For DMFS, adding platelet count to TNM classification had a tendency to improve prediction of distant metastasis (P = 0.086) (Figure 3C).Figure 3

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Thrombocytosis has been identified as an unfavorable prognostic factor in several types of cancer. This study aimed to evaluate the prognostic value of pretreatment platelet count in association with the TNM staging system and therapeutic regimens in patients with nasopharyngeal carcinoma (NPC).

Methods: A total of 2,626 patients with NPC were retrospectively analyzed. Platelet count >300 × 109/L was defined as thrombocytosis. Matched-pair analysis was performed between patients receiving chemoradiotherapy and radiotherapy.

Results: Multivariate analysis showed that platelet count was an independent unfavorable prognostic factor for overall survival (OS) [hazard ratio (HR) = 1.810, 95% confidence interval (CI) = 1.531–2.140, P < 0.001] and distant metastasis–free survival (DMFS) (HR = 1.873, 95% CI = 1.475–2.379, P < 0.001) in the entire patient cohort. Further subgroup analysis revealed that increased platelet count was an independent unfavorable prognostic factor for OS and DMFS in patients with NPC stratified by early and advanced T category, N category, or TNM classification (all P ≤ 0.001). Receiver operating characteristic (ROC) curves verified that the predictive value of TNM classification for OS was improved when combined with pretreatment platelet count (P = 0.030). Matched-pair analysis showed that chemoradiotherapy significantly improved OS only in advanced-stage NPC with thrombocytosis (HR = 0.416, 95% CI = 0.226–0.765, P = 0.005).

Conclusions: Pretreatment platelet count, when combined with TNM classification, is a useful indicator for metastasis and survival in patients with NPC. It may improve the predictive value of the TNM classification and help to identify patients likely to benefit from more aggressive therapeutic regimens.

No MeSH data available.


Related in: MedlinePlus