Pretreatment Thrombocytosis as a Prognostic Factor in Women with Gynecologic Malignancies: a Meta-analysis


Background: This study was performed to analyze the prognostic implications of pretreatment or preoperativethrombocytosis in women with gynecologic malignancies. Material and
Methods: We surveyed 2 medicaldatabases, PubMed and EMBASE, to identified all relevant studies. A total of 14 (n=3,490) that evaluated thelink between thrombocytosis and 5-year survival were included. REVMAN version 5.1 was used for our analysisand publication bias was evaluated using the Begg’s funnel plot and tested by STATA 11.0. Risk ratios (RRs) with95% confidence intervals (CIs) generated by the random effect model were used to assess the strength of anyassociation.
Results: 709(20.3%) of the 3,490 patients exhibited thrombocytosis (platelet counts >400×109/L) atprimary diagnosis, and their mortality was 1.62-fold higher compared with the others (RR=1.62, 95%CI= [1.28-2.05], p<0.0001). Thrombocytosis failed to have a stronger effect on the survival of advanced patients of stagesⅢ to Ⅳ in our study (n=478, RR=1.29, 95% CI= [1.13-1.48], p=0.0003), nor in women with cervical cancer instage ⅠB (n=1371, RR= 1.73, 95% CI= [1.71-2.58], p=0.007). In addition, when adjusted for different carcinoma,it was associated with worse prognosis for all except the ones with vulvar cancer (n=201, RR= 0.43, 95% CI=[0.14-1.29], p=0.13).
Conclusions: This meta-analysis indicated that thrombocytosis might be associated with aworse prognosis for patients with gynecologic malignancies but without specificity or sensitivity for the ones inadvanced stage. When adjusted for different gynecologic malignancies, it showed a significant effect on survivalof all except vulvar cancers.