Preoperative platelet count in esophageal squamous cell carcinoma: is it a prognostic factor?

PURPOSE: Platelet count is inversely related to prognosis in many cancers; however, its role in esophageal cancer is still controversial. The purpose of this study was to determine the prognostic value of preoperative platelet count in esophageal squamous cell carcinoma (ESCC). METHODS: From January 2006 to December 2008, a retrospective analysis of 425 consecutive patients with ESCC was conducted. A receiver operating characteristic (ROC) curve for survival prediction was plotted to verify the optimum cutoff point for preoperative platelet count. Univariate and multivariate analyses were performed to evaluate the prognostic parameters. RESULTS: A ROC curve for survival prediction was plotted to verify the optimum cutoff point for platelet count, which was 205 (× 10(9)/L). Patients with platelet count ≤ 205 had a significantly better 5-year survival than patients with a platelet count >205 (60.7 vs. 31.6 %, P < 0.001). The 5-year survival of patients either with platelet count ≤ 205 or >205 were similar (68.6 vs. 58.8 %, P = 0.085) when the nodes were negative. However, the 5-year survival of patients with platelet count ≤ 205 was better than that of patients with a platelet count >205 when the nodes were involved (32.0 vs. 12.7 %, P = 0.004). Multivariate analysis showed that platelet count (P = 0.013), T grade (P = 0.017), and N staging (P < 0.001) were independent prognostic factors. CONCLUSIONS: Preoperative platelet count is a predictive factor for long-term survival in ESCC, especially in nodal-positive patients. We conclude that 205 (×10(9)/L) may be the optimum cutoff point for platelet count in predicting survival in ESCC patients.

Risk factors for No. 12p and No. 12b lymph node metastases in advanced gastric cancer in China.

BACKGROUND: The risk factors for No. 12p and No. 12b lymph node (LN) metastases in advanced gastric cancer (GC) remain controversial. The aim of this study was to investigate the risk factors for No. 12p and No. 12b LN metastases in advanced GC. METHODS: From January 1999 to December 2005, a retrospective analysis of 163 patients with advanced GC who underwent D2 lymphadenectomy in addition to No. 12p and No. 12b LN dissections was conducted. Potential clinicopathological factors that could influence No. 12p and No. 12b LN metastases were statistically analyzed. RESULTS: There were 15 cases (9.2%) with No. 12p LN metastases and 5 cases (3.1%) with synchronous No. 12b LN metastases. A logistic regression analysis revealed that the Borrmann type (III/IV versus I/II, P = 0.029), localization (lesser/circular versus greater, P = 0.025), and depth of invasion (pT4 versus pT2/pT3, P = 0.009) were associated with 11.1-, 3.8-, and 5.6-fold increases, respectively, for risk of No. 12p and No. 12b LN metastases. A logistic regression analysis also showed that No. 5 (P = 0.006) and No. 12a (P = 0.004) LN metastases were associated with 6.9- and 11.3-fold increases, respectively, for risk of No. 12p and No. 12b LN metastases. In addition, significant differences in 5-year survival of patients with and without No. 12p and No. 12b LN metastases were observed (13.3% versus 35.1%, P = 0.022). CONCLUSION: We conclude that Borrmann type, localization, and depth of invasion are significant variables for identifying patients with No. 12p and No. 12b LN metastases. Individuals with No. 5 or No. 12a LN metastases should be on high alert for the possibility of additional metastases to the No. 12p and No. 12b LNs.