Preoperative platelet count as an independent predictor of long-term outcomes among patients undergoing resection for intrahepatic cholangiocarcinoma

J Surg Oncol. 2024 Oct;130(5):1042-1050. doi: 10.1002/jso.27806. Epub 2024 Aug 13.

Abstract

Background and objectives: An elevated platelet count may reflect neoplastic and inflammatory states, with cytokine-driven overproduction of platelets. The objective of this study was to evaluate the prognostic utility of high platelet count among patients undergoing curative-intent liver surgery for intrahepatic cholangiocarcinoma (ICC).

Methods: An international, multi-institutional cohort was used to identify patients undergoing curative-intent liver resection for ICC (2000-2020). A high platelet count was defined as platelets >300 *109/L. The relationship between preoperative platelet count, cancer-specific survival (CSS), and overall survival (OS) was examined.

Results: Among 825 patients undergoing curative-intent resection for ICC, 139 had a high platelet count, which correlated with multifocal disease, lymph nodes metastasis, poor to undifferentiated grade, and microvascular invasion. Patients with high platelet counts had worse 5-year (35.8% vs. 46.7%, p = 0.009) CSS and OS (24.8% vs. 39.8%, p < 0.001), relative to patients with a low platelet count. After controlling for relevant clinicopathologic factors, high platelet count remained an adverse independent predictor of CSS (HR = 1.46, 95% CI 1.02-2.09) and OS (HR = 1.59, 95% CI 1.14-2.22).

Conclusions: High platelet count was associated with worse tumor characteristics and poor long-term CSS and OS. Platelet count represents a readily-available laboratory value that may preoperatively improve risk-stratification of patients undergoing curative-intent liver resection for ICC.

Keywords: cancer‐specific survival; intrahepatic cholangiocarcinoma; overall survival; platelet count; prognosis; thrombocytosis.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Bile Duct Neoplasms* / blood
  • Bile Duct Neoplasms* / mortality
  • Bile Duct Neoplasms* / pathology
  • Bile Duct Neoplasms* / surgery
  • Cholangiocarcinoma* / blood
  • Cholangiocarcinoma* / mortality
  • Cholangiocarcinoma* / pathology
  • Cholangiocarcinoma* / surgery
  • Female
  • Follow-Up Studies
  • Hepatectomy* / mortality
  • Humans
  • Male
  • Middle Aged
  • Platelet Count
  • Prognosis
  • Retrospective Studies
  • Survival Rate