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Association between platelet count and hepatocellular carcinoma overall survival: a large retrospective cohort study.

Abstract：

OBJECTIVES:To explore the non-linear relationship between platelet count (PLT) and hepatocellular carcinoma (HCC) overall survival (OS). SETTING:The study was done in Sun Yat-sen University Cancer Center (SYSUCC) from January 2007 to May 2012, a total of 5005 consecutive participants at SYSUCC were retrospectively reviewed, and 979 patients with Barcelona clinic liver cancer (BCLC) stage B were selected for the final analysis. PARTICIPANTS:A total of 979 newly diagnosed patients with HCC with BCLC stage B were identified for the secondary analysis. Eight cases were excluded for missing data of PLT. MAIN OUTCOME MEASURES:Cox proportional hazard regression models were used to calculate multivariable-adjusted HRs and 95% CIs for HCC. The non-linear relationship was estimated through a restricted cubic spline regression, and a two-piecewise Cox proportional hazards model was further performed to calculate the threshold effect. We used multiple imputation to deal with the missing data. RESULTS:In the multivariate analysis, Log PLT was associated with a 91% risk increase in death (HR 1.91; 1.28 to 2.85) with adjustment for gender, Child-Pugh class, age × diameter of main tumour, both lobe with lesions × number of the intrahepatic lesions, alpha-fetoprotein (<25, ≥25) and lactic dehydrogenase (<245, ≥245). We also found a U-shape relationship between PLT and HCC OS at the inflexion point of 67.6×109/L. The HR was 0.12 (95% CI 0.03 to 0.52) for Log PLT≤10.83 and 3.07 (CI 1.91 to 4.92) for Log PLT>10.83 after adjusting for potential confounders. The core results were consistent with those from the sensitivity analysis. Besides, a significantly higher hazard risk was found in the patients with age <55, both lobes with lesions, tumour diameter >50, haemoglobin ≥120 and C reactive protein >10. CONCLUSION:PLT was nonlinearly associated with HCC OS.

journal_name

BMJ Open

journal_title

BMJ open

authors

Lu L,Su Z,Zheng P,Wu Z,Zhang Y,He H,Liu J,Lin S,Chen X

doi

10.1136/bmjopen-2020-038172

subject

Has Abstract

pub_date

2020-11-06 00:00:00

pages

e038172

issue

11

issn

2044-6055

pii

bmjopen-2020-038172

journal_volume

10

pub_type

杂志文章

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