Perioperative Thrombocytosis as a Predictor of Long-Term Survival in Colorectal Cancer Patients: A Retrospective Cohort Study

Sutrisno, Andi Tri; Syarifuddin, Erwin; Sampetoding, Samuel; Arsyad, Arham; Hamid, Firdaus; Masadah, Rina; Faruk, Muhammad

doi:10.31557/APJCP.2025.26.11.3951

Perioperative Thrombocytosis as a Predictor of Long-Term Survival in Colorectal Cancer Patients: A Retrospective Cohort Study

Document Type : Research Articles

Authors

¹ Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.

² Division of Digestive Surgery, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.

³ Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia.

⁴ Department of Clinical Microbiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.

⁵ Hasanuddin University Hospital, Makassar, Indonesia.

⁶ Department of Pathological Anatomy, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.

10.31557/APJCP.2025.26.11.3951

Abstract

Background: Colorectal cancer (CRC) is one of the leading causes of cancer-related death globally. Thrombocytosis, or increased platelet count, has been identified as a poor prognostic factor in various cancers, including CRC. This study aimed to investigate the relationship between preoperative and postoperative thrombocytosis and the survival rate of CRC patients. Methods: This retrospective cohort study enrolled 160 CRC patients who underwent surgery. Clinical data on preoperative and postoperative platelet counts, as well as survival rates, were collected from medical records. Thrombocytosis was defined as platelet levels exceeding 400 × 109/L. Survival analysis was performed using the Kaplan-Meier method, and relationships between variables were assessed with the Chi-squared test. Results: A total of 54 (33.7%) of patients experienced preoperative thrombocytosis and 23.1% experienced postoperative thrombocytosis. The 5-year cumulative survival rate of 160 CRC patients was 27.83 ± 16.97 months, with a mortality rate of 92.5%. There was a significant relationship between thrombocytosis and cancer stage (p=0.001) and tumor location (p=0.003), where patients with thrombocytosis were more likely to present with late-stage tumors and tumors of the rectum. Kaplan-Meier analysis showed that patients with thrombocytosis, especially those with postoperative thrombocytosis, had a significantly lower survival rate than patients without thrombocytosis. Conclusion: Thrombocytosis, particularly after surgery, is an important predictor of poor prognosis in CRC patients. Monitoring and managing thrombocytosis should be considered in efforts to improve patient survival.

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