1603 PRE-TREATMENT THROMBOCYTOSIS PORTRENDS MIXED CARCINOMA PATHOLOGY AT RADICAL CYSTECTOMY AND IS ASSOCIATED WITH POOR SURVIVAL
2011-04-01

You have accessJournal of UrologyBladder Cancer: Invasive1 Apr 20111603 PRE-TREATMENT THROMBOCYTOSIS PORTRENDS MIXED CARCINOMA PATHOLOGY AT RADICAL CYSTECTOMY AND IS ASSOCIATED WITH POOR SURVIVAL Tilman Todenhoefer, Markus Renninger, Christian Schwentner, Arnulf Stenzl, and Georgios Gakis Tilman TodenhoeferTilman Todenhoefer Tuebingen, Germany More articles by this author , Markus RenningerMarkus Renninger Tuebingen, Germany More articles by this author , Christian SchwentnerChristian Schwentner Tuebingen, Germany More articles by this author , Arnulf StenzlArnulf Stenzl Tuebingen, Germany More articles by this author , and Georgios GakisGeorgios Gakis Tuebingen, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2708AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Reactive preoperative thrombocytosis is reported in a variety of solid tumors, i.e. endometrium and ovarian cancer, and has been identified as a new marker for aggressive tumor biology. The aim of this study was to investigate the oncological significance of pre-treatment thrombocytosis in patients with invasive bladder cancer undergoing radical cystectomy in view of the scarce data given in current literature. METHODS A consecutive series of 277 patients undergoing radical cystectomy between 1999–2010 was considered for analysis. Different clinical and histopathological parameters were assessed. Elevated platelet count (PLT) was defined as >450x109/l. The median follow-up was 30 months (6–116). The Fisher Exact test and Cox-regression analysis were used for uni- and multivariate analysis of risk factors, and log-rank test for cancer-specific survival (CSS). RESULTS Of the 277 patients, 26 (9.4%) had elevated and 251 (90.6%) normal platelet count, respectively. Mixed carcinoma pathology was present in 17 of the 277 patients (6.1%). In univariate analysis, elevated PLT was associated with elevated leukocyte count, decreased hemoglobine level, increased tumor size (all p<0.0001) and mixed carcinoma pathology (p=0.018). The 3-year CSS in patients with normal and elevated PLT count was 60.1% and 31.6%, respectively (p=0.0006). Likewise, in patients with pure and mixed urothelial carcinoma pathology, 3-year CSS was 59.4% and 18.9%, respectively (p=0.0004). In multivariate analysis, adjusted for tumor stage, lymph node tumor involvement and soft tissue surgical margins, CSS was significantly lower in patients with locally advanced disease (≥pT3a) (p<0.0001), positive soft tissue surgical margins (p=0.01) and thrombocytosis (p=0.04). CONCLUSIONS The presence of thrombocytosis at the time of radical cystectomy portrends unfavourable prognosis and is often associated mixed carcinoma pathology indicating aggressive tumor behaviour. Its association with other hematological disorders, i.e leukocytosis, anemia and tumor size, suggests that thrombocytes may play a role in tumor growth and progression. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e643 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tilman Todenhoefer Tuebingen, Germany More articles by this author Markus Renninger Tuebingen, Germany More articles by this author Christian Schwentner Tuebingen, Germany More articles by this author Arnulf Stenzl Tuebingen, Germany More articles by this author Georgios Gakis Tuebingen, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...