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Clinicopathological and prognostic significance of pretreatment thrombocytosis in patients with endometrial cancer: a meta-analysis

Authors Bai YY, Du L, Jing L, Tian T, Liang X, Jiao M, Nan KJ, Guo H, Ruan ZP

Received 5 September 2018

Accepted for publication 8 February 2019

Published 8 May 2019 Volume 2019:11 Pages 4283—4295

DOI https://doi.org/10.2147/CMAR.S186535

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Rituraj Purohit


Yi-Yang Bai,1,* Lan Du,2,* Li Jing,1 Tao Tian,1 Xuan Liang,1 Min Jiao,1 Ke-Jun Nan,1 Hui Guo,1 Zhi-Ping Ruan1

1Department of Medical Oncology, The First Affiliated Hospital, College of Medicine of Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 2Department of Obstetrics and Gynecology, Xi’an Angel Women’s and Children’s Hospital, Xian, Shaanxi, People’s Republic of China
 
*These authors contributed equally to this work

Background:
The prognostic and clinicopathological role of pretreatment thrombocytosis in cancer has been widely studied, but conclusions in endometrial cancer (EnCa) remain controversial. Therefore, we conducted a meta-analysis to assess the pathologic and prognostic impacts of pretreatment thrombocytosis in patients with EnCa.
Methods: We searched PubMed, Embase, SpringerLink, ScienceDirect and China National Knowledge Infrastructure databases. Pooled HR or OR with their 95% CIs were applied to assess the association of pretreatment thrombocytosis with survival outcomes and clinical parameters of EnCa patients.
Results: In total, 10 studies containing 2,995 cases of EnCa met the criteria. The results suggested that pretreatment thrombocytosis was significantly associated with high International Federation of Gynecology and Obstetrics (FIGO) stage (pooled OR 3.45, 95% CI 1.68–7.08, P=0.001), poor tumor differentiation (pooled OR 2.00, 95% CI 1.22–3.29, P=0.006), lymph-vascular space invasion (pooled OR 2.04, 95% CI 1.35–3.07, P=0.001); myometrial invasion (pooled OR 2.14, 95% CI 1.39–3.32, P=0.001); cervical involvement (pooled OR 2.54, 95% CI 1.56–4.15, P=0.000) and lymph node metastasis (OR 3.15, 95% CI 1.71–5.80, P=0.001). No significant difference existed between pretreatment thrombocytosis and overall survival (P=0.012), cancer/disease-specific survival (P=0.07) or disease-free survival (P=0.25).
Conclusion: pretreatment thrombocytosis was associated with advanced clinicopathological features in patients with EnCa, which may serve as a potential therapeutic target for EnCa.

Keywords: thrombocytosis, endometrial cancer, prognosis, meta-analysis

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