Prior to the addition of chemotherapy to radiation, thrombocytosis was seen as a poor prognostic factor for women with advanced cervical cancer. The objective of this study was to see in the chemoradiation era whether thrombocytosis was still a prognostic factor.METHODS:
An IRB study was performed analyzing all patients with cervical cancer receiving primary chemoradiation as therapy with a diagnosis between January 1, 2001 and December 31, 2011. Minimum follow up was 30 months. Records were examined for initial platelet count at diagnosis, stage, grade, histology and survival. Only patients receiving chemoradiation with stage IIa-Vb cervical cancer were studied included in the final analysis.RESULTS:
209 women with cervical cancer were diagnosed with 173 women treated with primary chemoradiation. The most common stage was IIIb (88, 50.9%). The mean platelet counts of those receiving chemoradiation was significantly higher (396k/ml; 95%CI 376-416k) than those with lower stage disease (313k/ml; 292-334k)(p<0.001). Of the 173 patients, 42 (24.3%) had a platelet count > 450k/ml and 24 (13.9%) had a platelet count >500k/ml. Patients who died of disease had significantly higher initial platelet counts (mean 433k/ml; 95%CI 407-458k) than those who were alive at the completion of follow-up (mean 326k/ml; 95%CI 303-350k). None of the patients with an initial platelet count >500k/ml were alive at the time of follow-up.CONCLUSION:
High platelet count at initial diagnosis is a poor prognostic factor in women with cervical cancer treated by chemoradiation.