Preoperative platelet count and survival prognosis in resected pancreatic ductal adenocarcinoma

Abstract

Background: High platelet counts are associated with an adverse effect on survival in various neoplastic entities. The prognostic relevance of preoperative platelet count in pancreatic cancer has not been clarified.

Methods: We performed a retrospective review of 205 patients with ductal adenocarcinoma who underwent surgical resection between 1990 and 2003. Demographic, surgical, and clinicopathologic variables were collected. A cutoff of 300,000/mul was used to define high platelet count.

Results: Of the 205 patients, 56 (27.4%) had a high platelet count, whereas 149 patients (72.6%) comprised the low platelet group. The overall median survival was 17 (2-178) months. The median survival of the high platelet group was 18 (2-137) months, and that of the low platelet group was 15 (2-178) months (p = 0.7). On multivariate analysis, lymph node metastasis, vascular invasion, positive margins, and CA 19-9 > 200 U/ml were all significantly associated with poor survival.

Conclusions: There is no evidence to support preoperative platelet count as either an adverse or favorable prognostic factor in pancreatic ductal adenocarcinoma. Use of 5-year actual survival data confirms that lymph node metastases, positive margins, vascular invasion, and CA 19-9 are predictors of poor survival in resected pancreatic cancer.

Fig. 1

Overall survival of patients with resected ductal pancreatic adenocarcinoma. + indicates alive at final follow-up (n = 8) 304 × 228 mm 304 × 228 mm (400 × 400 dpi)

Fig. 2

Survival following resection for pancreatic cancer in patients with high and low preoperative platelet counts. Low (solid line):<300 (n = 149). High (dashed line): ≥300 (n = 56). + indicates alive at final follow-up (n = 8) + 304 × 228 mm (400 × 400 dpi)