Ha Yun-Sok, Chung Jae-Wook, Chun So Young, Choi Seock Hwan, Lee Jun Nyung, Kim Bum Soo, Kim Hyun Tae, Kim Tae-Hwan, Byun Seok-Soo, Hwang Eu Chang, Kang Seok Ho, Hong Sung-Hoo, Chung Jinsoo, Kwak Cheol, Kim Yong-June, Kwon Tae Gyun
Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Urology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Oncotarget. 2017 Mar 11;8(38):64449-64458. doi: 10.18632/oncotarget.16136. eCollection 2017 Sep 8.
The prognostic significance of preoperative thrombocytosis (TC) in renal cell carcinoma (RCC) is not without some debate. The aim of the present multi-institutional study was to determine the association of preoperative TC with the clinicopathological features and prognosis of localized RCC patients who underwent surgery in a large cohort.
A study involving 8 institutions, and 4,376 patients with pT1 and pT2 RCC from the Korean renal cell carcinoma (KORCC) database, was conducted. TC was defined as a platelet count ≥400,000/μL. Patients were divided into 2 groups based on the presence of preoperative TC. Clinicopathological variables and survival rates were compared between the 2 groups.
Out of the 4,376 patients in the study, 106 (2.4%) had preoperative TC. Compared to patients without TC, these patients had a lower body mass index. Additionally, these patients had more advanced stage tumors with a higher Fuhrman grade, and higher incidence of symptoms at the time of diagnosis. Kaplan-Meier curves revealed that patients with TC had a significantly lower rate of recurrence-free survival (RFS). Furthermore, a lower rate of overall survival (OS) was exhibited amongst patients with TC. Multivariate analysis revealed that TC was an independent prognostic factor in terms of the RFS and OS.
TC appeared to be an important prognostic determinant in localized RCC. Furthermore, preoperative platelet count may be clinically useful for risk stratification of patients with surgically treated localized RCC.
术前血小板增多症（TC）在肾细胞癌（RCC）中的预后意义存在一定争议。本多机构研究的目的是确定术前TC与一大群接受手术的局限性RCC患者的临床病理特征及预后之间的关联。
开展了一项涉及8家机构的研究，纳入了来自韩国肾细胞癌（KORCC）数据库的4376例pT1和pT2期RCC患者。TC定义为血小板计数≥400,000/μL。根据术前是否存在TC将患者分为两组。比较两组之间的临床病理变量和生存率。
在该研究的4376例患者中，106例（2.4%）有术前TC。与无TC的患者相比，这些患者的体重指数较低。此外，这些患者的肿瘤分期更晚，Fuhrman分级更高，诊断时症状发生率更高。Kaplan-Meier曲线显示，有TC的患者无复发生存率（RFS）显著更低。此外，有TC的患者总生存率（OS）更低。多变量分析显示，就RFS和OS而言，TC是一个独立的预后因素。
TC似乎是局限性RCC的一个重要预后决定因素。此外，术前血小板计数可能在临床上有助于对接受手术治疗的局限性RCC患者进行风险分层。
