PO_II_L: Pathology and Oncology II. Lectures
Zoltán Herold1,2, A. Marcell Szász1, Magdolna Dank1, Anikó Somogyi2
1 Division of Oncology, Department of Internal Medicine and Oncology, Semmelweis University, Budapest
2 Department of Internal Medicine and Hematology, Semmelweis University, Budapest
Introduction: Pre- or postoperative elevated platelet count is a known poor prognostic sign of colorectal cancer (CRC) survival. In a recent study we have found that individualized measures of platelet changes can predict CRC survival more precisely.
Aims: A large-cohort retrospective study was designed to evaluate the changes in platelet counts of CRC patients during the course of the disease.
Method: An interim analysis of 3181 observations of 525 patients was analyzed (number of average visits: 6; min: 1; max: 28). Complete blood count and anamnestic data was collected from eMedSolution, the medical database of Semmelweis University. Changes in platelet counts were determined relative to the value at CRC diagnosis (platelet change measure – PCM). Descriptive statistical methods and natural spline-adjusted liner mixed effect modeling was used to analyze the data.
Results: 213 and 53 of the 525 patient (40.6% and 10.7%) died during the study due to CRC- and non-cancer related causes; respectively. 207 patients had metastasis at the time of diagnosis, and metastasis developed in an additional 63 patient as the disease progressed. Average observation time of surviving, died-of-CRC and died-of-non-cancer-cause patients was 85.7 ± 32.6, 27.8 ± 22.0 and 53.2 ± 39.4 months, respectively.
A slow, decreasing tendency in PCM could have been observed in surviving patient (decrease between 0.13 – 0.20%/month, p < 0.0001). In contrast, the following was observed in those patients who died: Three intervals were identified, around 45 months after CRC diagnosis, where the majority (76.0%) of CRC-caused deaths occurred, PCM significantly increased (p < 0.0001). In the remaining months, a significantly larger PCM decrease (> 2-times, p < 0.0001) was observed than those of in surviving patients.
Conclusion: Results of the current study suggests that both the increase, short after tumor resection, and the sudden decrease of platelet counts at later stages of the disease may be a possible early indication of disease progression. The described effect of platelets may ultimately bring the attention of the practicing oncologist for further therapy decisions in a timely manner.
Funding: Supported by the UNKP-20-4-I New National Excellence Program of the Ministry for Innovation and Technology from the source of the National Research, Development and Innovation Fund.
Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine