신세포암에서 예후인자로서의 혈소판증가증

Abstract

Purpose Thrombocytosis has been reported in many types of malignancies and it has been studied as a prognostic factor. To better define the relationship between the platelet count and survival, we performed a retrospective analysis of patients with thrombocytosis and renal cell carcinoma, and some of whom had a lower survival rate than those with a normal platelet count.

Materials and Methods We reviewed the medical records of patients with renal cell carcinoma and who had undergone radical nephrectomy between January, 1995 and December, 2004. A total of 112 patients were treated by radical nephrectomy for renal cell carcinoma. Among them, 67 patients without primary thrombocytosis, no familial history of renal cell carcinoma and no history of adjuvant therapy were enrolled in this study. The patients were divided into a normal platelet count group and a thrombocytosis group (greater than 400,000/µl) according to the perioperative platelet count. The two groups were compared pathologically and clinically, including comparing the prognosis.

Results The mean follow-up was 55.8 months (range: 21 to 80). Thrombocytosis was present in 19 patients. The mean survival for the normal platelet count group was 67.8±39.36 months, compared with 41.4±30.65 months for the thrombocytosis group (p<0.05). The difference of survival between the 2 groups remained significant when controlling for the established prognostic indicators like the pathological stage, nuclear grade and cell types.

Conclusions This study documents the association of thrombocytosis with decreased survival in patients with renal cell carcinoma. The peri-operative platelet count appears to be a significant independent predictor for determining the prognosis for patients with renal cell carcinoma.