Preoperative thrombocytosis as a prognostic factor in endometrioid-type endometrial carcinoma

BACKGROUND: The impact of preoperative thrombocytosis as a prognostic factor in endometrial carcinoma (EC) remains uncertain and has never been examined in Saudi Arabia. OBJECTIVES: To determine the prevalence of preoperative thrombocytosis (platelet count >400 000/μL), and its prognostic signifi...

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Main Authors: Ahmed Abu-Zaid, Mohannad Alsabban, Mohammed Abuzaid, Osama AlOmar, Hany Salem, Ismail A. Al-Badawi
Format: Article
Language:English
Published: King Faisal Specialist Hospital and Research Centre 2017-09-01
Series:Annals of Saudi Medicine
Online Access:https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2017.393
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author Ahmed Abu-Zaid
Mohannad Alsabban
Mohammed Abuzaid
Osama AlOmar
Hany Salem
Ismail A. Al-Badawi
author_facet Ahmed Abu-Zaid
Mohannad Alsabban
Mohammed Abuzaid
Osama AlOmar
Hany Salem
Ismail A. Al-Badawi
author_sort Ahmed Abu-Zaid
collection DOAJ
description BACKGROUND: The impact of preoperative thrombocytosis as a prognostic factor in endometrial carcinoma (EC) remains uncertain and has never been examined in Saudi Arabia. OBJECTIVES: To determine the prevalence of preoperative thrombocytosis (platelet count >400 000/μL), and its prognostic significance for clinicopathological factors and survival in Saudi patients with endometrioid-type EC. DESIGN: A retrospective cross-sectional study from January 2010 to December 2013. SETTING: A referral tertiary healthcare institute. PATIENTS AND METHODS: Patients who underwent staging surgery for primary endometrioid-type EC were retrospectively analyzed for perioperative details: age, preoperative platelet count, International Federation of Gynecology and Obstetrics (FIGO) stage, endometrioid grade, recurrence, disease-free survival (DFS) and overall survival (OS). Survival analysis was conducted using Kaplan-Meier estimates and a Cox proportional hazards model. MAIN OUTCOME MEASURES: Prevalence of preoperative thrombocytosis, DFS and OS. RESULTS: In 162 patients who met inclusion criteria, the frequency of preoperative thrombocytosis was 8.6% (n=14). Patients with advanced FIGO disease (stages III–IV) and recurrence had significantly higher mean preoperative platelet counts than patients with early FIGO disease (stages I-II) and no recurrence (P=.0080 and P=.0063, respectively). Patients with thrombocytosis had statistically significant higher rates of advanced FIGO stages III-IV disease, unfavorable grades II-III endometrioid histology and recurrence than patients with preoperative platelet counts ≤400 000/μL (P<.001, P<.0105 and P<.001, respectively). In a univariate analysis, patients with preoperative thrombocytosis had statistically lower mean DFS and OS rates than patients without thrombocytosis (P<.0001 and P<.0001, respectively). In a multivariate analysis, thrombocytosis was not an independent prognostic factor of DFS and OS. CONCLUSION: The frequency of preoperative thrombocytosis is not uncommon. Also, preoperative thrombocytosis is associated with poor clinicopathological prognostic factors, and poor survival outcomes in a univariate but not multivariate analysis. LIMITATION: The retrospective study design, sample size and lack of exploration of other clinicopathological factors.
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spelling doaj.art-8aaf19a07e624c569a3d51d8285027692022-12-22T01:57:41ZengKing Faisal Specialist Hospital and Research CentreAnnals of Saudi Medicine0256-49470975-44662017-09-0137539340010.5144/0256-4947.2017.393asm-5-393Preoperative thrombocytosis as a prognostic factor in endometrioid-type endometrial carcinomaAhmed Abu-Zaid0Mohannad Alsabban1Mohammed Abuzaid2Osama AlOmar3Hany Salem4Ismail A. Al-Badawi5From the College of Medicine, Alfaisal University, Riyadh, Saudi ArabiaFrom the Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, King Fahd Medical City, Riyadh, Saudi ArabiaFrom the Department of Obstetrics and Gynecology, King Fahd Medical City, Riyadh, Saudi ArabiaFrom the College of Medicine, Alfaisal University, Riyadh, Saudi ArabiaFrom the College of Medicine, Alfaisal University, Riyadh, Saudi ArabiaFrom the College of Medicine, Alfaisal University, Riyadh, Saudi ArabiaBACKGROUND: The impact of preoperative thrombocytosis as a prognostic factor in endometrial carcinoma (EC) remains uncertain and has never been examined in Saudi Arabia. OBJECTIVES: To determine the prevalence of preoperative thrombocytosis (platelet count >400 000/μL), and its prognostic significance for clinicopathological factors and survival in Saudi patients with endometrioid-type EC. DESIGN: A retrospective cross-sectional study from January 2010 to December 2013. SETTING: A referral tertiary healthcare institute. PATIENTS AND METHODS: Patients who underwent staging surgery for primary endometrioid-type EC were retrospectively analyzed for perioperative details: age, preoperative platelet count, International Federation of Gynecology and Obstetrics (FIGO) stage, endometrioid grade, recurrence, disease-free survival (DFS) and overall survival (OS). Survival analysis was conducted using Kaplan-Meier estimates and a Cox proportional hazards model. MAIN OUTCOME MEASURES: Prevalence of preoperative thrombocytosis, DFS and OS. RESULTS: In 162 patients who met inclusion criteria, the frequency of preoperative thrombocytosis was 8.6% (n=14). Patients with advanced FIGO disease (stages III–IV) and recurrence had significantly higher mean preoperative platelet counts than patients with early FIGO disease (stages I-II) and no recurrence (P=.0080 and P=.0063, respectively). Patients with thrombocytosis had statistically significant higher rates of advanced FIGO stages III-IV disease, unfavorable grades II-III endometrioid histology and recurrence than patients with preoperative platelet counts ≤400 000/μL (P<.001, P<.0105 and P<.001, respectively). In a univariate analysis, patients with preoperative thrombocytosis had statistically lower mean DFS and OS rates than patients without thrombocytosis (P<.0001 and P<.0001, respectively). In a multivariate analysis, thrombocytosis was not an independent prognostic factor of DFS and OS. CONCLUSION: The frequency of preoperative thrombocytosis is not uncommon. Also, preoperative thrombocytosis is associated with poor clinicopathological prognostic factors, and poor survival outcomes in a univariate but not multivariate analysis. LIMITATION: The retrospective study design, sample size and lack of exploration of other clinicopathological factors.https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2017.393
spellingShingle Ahmed Abu-Zaid
Mohannad Alsabban
Mohammed Abuzaid
Osama AlOmar
Hany Salem
Ismail A. Al-Badawi
Preoperative thrombocytosis as a prognostic factor in endometrioid-type endometrial carcinoma
Annals of Saudi Medicine
title Preoperative thrombocytosis as a prognostic factor in endometrioid-type endometrial carcinoma
title_full Preoperative thrombocytosis as a prognostic factor in endometrioid-type endometrial carcinoma
title_fullStr Preoperative thrombocytosis as a prognostic factor in endometrioid-type endometrial carcinoma
title_full_unstemmed Preoperative thrombocytosis as a prognostic factor in endometrioid-type endometrial carcinoma
title_short Preoperative thrombocytosis as a prognostic factor in endometrioid-type endometrial carcinoma
title_sort preoperative thrombocytosis as a prognostic factor in endometrioid type endometrial carcinoma
url https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2017.393
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