Pretreatment platelet count improves the prognostic performance of the TNM staging system and aids in planning therapeutic regimens for nasopharyngeal carcinoma:a singleinstitutional study of 2,626 patients

作     者：Yu-Pei Chen Bing-Cheng Zhao Chen Chen Lu-Jun Shen Jin Gao Zhuo-Yao Mai Meng-Kun Chen Gang Chen Fang Yan Su Liu Yun-Fei Xia 

作者机构：Department of Radiation OncologyState Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine Sun Yat-sen University Cancer Center Zhongshan School of MedicineSun Yat-sen University Department of Radiation OncologyAnhui Provincial Hospital Department of Radiation OncologySun Yat-sen University Cancer Center 

出 版 物：《Chinese Journal of Cancer》 (Chinese Journal of Cancer)

年 卷 期：2015年第34卷第3期

页      面：137-146页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：supported by grants from the Hi-Tech Research and Development Program of China(No.2006AA02Z4B4) the National Natural Science Foundation of China(No.30770641 No.31170805) 

主　　题：血小板计数 治疗方案 鼻咽癌 TNM 预处理 患者 预后 系统 

摘      要：Introduction:Thrombocytosis has been identified as an unfavorable prognostic factor in several types of *** study aimed to evaluate the prognostic value of pretreatment platelet count in association with the TNM staging system and therapeutic regimens in patients with nasopharyngeal carcinoma(NPC).Methods:A total of 2,626 patients with NPC were retrospectively *** count 300 × 10~9/L was defined as ***-pair analysis was performed between patients receiving chemoradiotherapy and ***:Multivariate analysis showed that platelet count was an independent unfavorable prognostic factor for overall survival(OS)[hazard ratio(HR) = 1.810,95%confidence interval(CI) = 1.531-2.140,P 0.001]and distant metastasis-free survival(DMFS)(HR = 1.873,95%CI = 1.475-2.379,P 0.001) in the entire patient *** subgroup analysis revealed that increased platelet count was an independent unfavorable prognostic factor for OS and DMFS in patients with NPC stratified by early and advanced T category,N category,or TNM classification(all P 0.001).Receiver operating characteristic(ROC) curves verified that the predictive value of TNM classification for OS was improved when combined with pretreatment platelet count(P = 0.030).Matched-pair analysis showed that chemoradiotherapy significantly improved OS only in advanced-stage NPC with thrombocytosis(HR = 0.416,95%CI = 0.226-0.765,P = 0.005).Conclusions:Pretreatment platelet count,when combined with TNM classification,is a useful indicator for metastasis and survival in patients with *** may improve the predictive value of the TNM classification and help to identify patients likely to benefit from more aggressive therapeutic regimens.