Platelet Count and Survival after Cancer

Abstract

Thrombocytosis is associated with cancer progression and death for many cancer types. It is unclear if platelet count is also associated with cancer survival. We conducted a cohort study of 112,231 adults in Ontario with a diagnosis of cancer between January 2007 and December 2016. We included patients who had a complete blood count (CBC) completed in the 30 days prior to their cancer diagnosis. Subjects were assigned to one of three categories according to platelet count: low (≤25th percentile), medium (>25 to <75th percentile), and high (≥75th percentile). Study subjects were followed from the date of their cancer diagnosis for cancer-specific death. Of the 112,231 eligible cancer patients in the cohort study, 40,329 (35.9%) died from their cancer in the follow-up period. Relative to those with a medium platelet count, the rate of cancer-specific death was higher among individuals with a high platelet count (HR 1.52; 95%CI 1.48-1.55) and was lower among individuals with a low platelet count (HR 0.91; 95%CI 0.88-0.93). A high platelet count was associated with poor survival for many cancer types. Platelet count could potentially be used as a risk stratification measure for cancer patients.

Keywords: cancer survival; marginal structural model; platelet count; platelets; thrombocytosis.

Figure 1

Cancer-specific survival by baseline platelet count category, for select cancers. (a) All cancers (n = 112,231); (b) colon (n = 17,259); (c) lung (n = 20,583); (d) breast (n = 9857); (e) prostate (n = 8587); (f) ovary (n = 3085); (g) stomach (n = 3365).

Figure 1

Cancer-specific survival by baseline platelet count category, for select cancers. (a) All cancers (n = 112,231); (b) colon (n = 17,259); (c) lung (n = 20,583); (d) breast (n = 9857); (e) prostate (n = 8587); (f) ovary (n = 3085); (g) stomach (n = 3365).

Figure 1

Cancer-specific survival by baseline platelet count category, for select cancers. (a) All cancers (n = 112,231); (b) colon (n = 17,259); (c) lung (n = 20,583); (d) breast (n = 9857); (e) prostate (n = 8587); (f) ovary (n = 3085); (g) stomach (n = 3365).

Figure 1

Cancer-specific survival by baseline platelet count category, for select cancers. (a) All cancers (n = 112,231); (b) colon (n = 17,259); (c) lung (n = 20,583); (d) breast (n = 9857); (e) prostate (n = 8587); (f) ovary (n = 3085); (g) stomach (n = 3365).

Figure 2

Cancer-specific survival by baseline platelet count category, for ovarian cancer patients. (a) Ovary (stage I/II patients) (n = 651); (b) ovary (stage III/IV patients) (n = 1425).

Figure 3

Median platelet count moving average (period of 5) in the 104 weeks (2 years) preceding death, among patients with a cancer-specific death. (a) Female patients; (b) male patients.