Department of Medicine, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
Department of Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany.
Curr Oncol. 2022 Feb 28;29(3):1475-1487. doi: 10.3390/curroncol29030124.
The prognostic role of platelet count in hepatocellular carcinoma (HCC) remains unclear, and in fact both thrombocytopenia and thrombocytosis are reported as predictors of unfavourable outcomes. This study aimed to clarify the prognostic value of preoperative platelet count in potentially resectable HCC. We retrospectively reviewed 128 patients who underwent hepatic resection for HCC at a tertiary academic centre (2007−2019). Patient data were modelled by regression analysis, and platelet count was treated as a continuous variable. 89 patients had BCLC 0/A tumours and 39 had BCLC B tumours. Platelet count was higher in patients with larger tumours and lower in patients with higher MELD scores, advanced fibrosis, and portal hypertension (p < 0.001 for all listed variables). After adjusting for BCLC stage and tumour diameter, low platelet count associated with reduced overall survival (hazard ratio 1.25 per 50/nL decrease in platelet count, 95% confidence interval (CI) 1.02−1.53, p = 0.034) and increased perioperative mortality (odds ratio 1.96 per 50/nL decrease in platelet count, 95% CI 1.19−3.53, p = 0.014). Overall, low platelet count correlates with increased liver disease severity, inferior survival, and excess perioperative mortality in resectable HCC. These insights might be applied in clinical practice to better select patients for resection.
血小板计数在肝细胞癌 (HCC) 中的预后作用尚不清楚，事实上，血小板减少症和血小板增多症均被报道为不良预后的预测因子。本研究旨在阐明术前血小板计数对潜在可切除 HCC 的预后价值。我们回顾性分析了在一家三级学术中心接受肝切除术治疗 HCC 的 128 例患者（2007 年至 2019 年）。通过回归分析对患者数据进行建模，并将血小板计数视为连续变量。89 例患者为 BCLC 0/A 肿瘤，39 例患者为 BCLC B 肿瘤。血小板计数在肿瘤较大的患者中较高，在 MELD 评分较高、纤维化程度较高和门静脉高压的患者中较低（所有列出的变量 p < 0.001）。在调整了 BCLC 分期和肿瘤直径后，低血小板计数与总生存期缩短相关（血小板计数每降低 50/nL，风险比为 1.25，95%置信区间为 1.02−1.53，p = 0.034），并增加了围手术期死亡率（血小板计数每降低 50/nL，比值比为 1.96，95%置信区间为 1.19−3.53，p = 0.014）。总体而言，低血小板计数与可切除 HCC 中肝脏疾病严重程度增加、生存状况较差和围手术期死亡率增加相关。这些发现可能适用于临床实践，以更好地选择接受切除术的患者。
