Association of Platelet Count and Mean Platelet Volume with Overall Survival in Patients with Cirrhosis and Unresectable Hepatocellular Carcinoma (Englisch)

in Liver Cancer ; 8 , 3 ; 203-217
Liver Cancer
S. Karger AG , Basel, Switzerland; 2018

Background: Platelets have been reported to influence tumor biology and may promote metastasis. Traditionally, thrombocytopenia, a hallmark of cirrhosis, was associated with hepatocellular carcinoma (HCC) development. However, the impact of platelet count on outcome in patients with established HCC is not well studied. Methods: Outcomes of patients with cirrhosis diagnosed with HCC between 1995 and 2013 (derivation cohort) and 2000–2016 (validation cohort) who were not eligible for surgical treatment and did not receive antiplatelet therapy were retrospectively studied. Thrombocytopenia was defined as platelet count < 150 g/L. High mean platelet volume (MPV) was defined as ≥median value of the respective cohort (derivation cohort: ≥11 fL; validation cohort: ≥10.6 fL). Results: Among 626 patients with unresectable HCC, thrombocytopenia was present in 378 (60.4%) and was associated with favorable baseline tumor characteristics: lower diameter of the largest nodule (5.6 ± 3.2 vs. 7.6 ± 4.2 cm), less extrahepatic spread (9.5 vs. 20.2%, both p < 0.001), less macrovascular invasion (21.2 vs. 31.0%, p = 0.005), and lower BCLC stages (63.0 vs. 73.4% BCLC C/D; p = 0.007) as compared to patients with normal platelet count. On univariate analysis, thrombocytopenia and larger MPV were associated with longer overall survival (OS) (thrombocytopenia: median OS [95% CI], 11.5 [9.3–13.8] vs. 5.5 [3.8–7.1] months; p = 0.001; MPV ≥11 fL: 11.7 [9.1–14.2] vs. 6.0 [4.4–7.6] months; p < 0.001). In multivariate analysis, the combined variable of thrombocytopenia and larger MPV was independently associated with longer OS (HR [95% CI], 0.80 [0.65–0.98]; p = 0.029). These results were confirmed in an independent external validation cohort of 525 patients with cirrhosis and HCC. Again, patients with thrombocytopenia and high MPV had significantly longer OS (15.3 [11.7–18.9] vs. 9.3 [7.4–11.2] months; p < 0.001). Conclusions: Thrombocytopenia and higher MPV are associated with better outcome in patients with advanced HCC. These findings may prompt further clinical research on additive antiplatelet therapy in the prevention and management of HCC.

Wie erhalte ich diesen Titel?
Download
Kommerziell Vergütung an den Verlag: 24,00 € Grundgebühr: 4,00 € Gesamtpreis: 28,00 €
Akademisch Vergütung an den Verlag: 10,00 € Grundgebühr: 2,00 € Gesamtpreis: 12,00 €

Dokumentinformationen


Inhaltsverzeichnis – Band 8, Ausgabe 3

Zeige alle Jahrgänge und Ausgaben

Die Inhaltsverzeichnisse werden automatisch erzeugt und basieren auf den im Index des TIB-Portals verfügbaren Nachweisen der enthaltenen Aufsätze. Die Anzeige der Jahrgänge kann aufgrund fehlender Aufsatznachweise unvollständig oder lückenhaft sein, obwohl die Zeitschrift komplett in der TIB verfügbar ist.

143
Pembrolizumab for the Treatment of Hepatocellular Carcinoma
Kudo, Masatoshi | 2019
155
Development of a PD-L1-Expressing Orthotopic Liver Cancer Model: Implications for Immunotherapy for Hepatocellular Carcinoma
Ou, Da-Liang / Lin, Yu-Yang / Hsu, Chia-Lang / Lin, Yin-Yao / Chen, Chia-Wei / Yu, Jhang-Sian / Miaw, Shi-Chuen / Hsu, Ping-Ning / Cheng, Ann-Lii / Hsu, Chiun | 2018
172
Multibipolar Radiofrequency Ablation for the Treatment of Mass-Forming and Infiltrative Hepatocellular Carcinomas > 5 cm: Long-Term Results
N’Kontchou, Gisele / Nault, Jean-Charles / Sutter, Olivier / Bourcier, Valerie / Coderc, Emmanuelle / Grando, Veronique / Nahon, Pierre / Ganne-Carrié, Nathalie / Diallo, Abou / Sellier, Nicolas et al. | 2018
186
Combined Transarterial Embolization/Chemoembolization-Based Locoregional Treatment with Sorafenib Prolongs the Survival in Patients with Advanced Hepatocellular Carcinoma and Preserved Liver Function: A Propensity Score Matching Study
Chien, Shih-Chieh / Chen, Chiung-Yu / Cheng, Pin-Nan / Liu, Yi-Shan / Cheng, Hsiu-Chi  / Chuang, Chiao-Hsiung / Chang, Ting-Tsung / Chiu, Hong-Chi / Lin, Yih-Jyh / Chiu, Yen-Cheng | 2018
203
Association of Platelet Count and Mean Platelet Volume with Overall Survival in Patients with Cirrhosis and Unresectable Hepatocellular Carcinoma
Scheiner, Bernhard / Kirstein, Martha / Popp, Sabine / Hucke, Florian / Bota, Simona / Rohr-Udilova, Nataliya / Reiberger, Thomas / Müller, Christian / Trauner, Michael / Peck-Radosavljevic, Markus et al. | 2018
218
APPLE News
| 2019
219
The APPLE Association President's Message
| 2019
220
APPLE 2019
| 2019

Ähnliche Titel