Clinical Research Papers:
Impact of preoperative thrombocytosis on prognosis after surgical treatment in pathological T1 and T2 renal cell carcinoma: results of a multi-institutional comprehensive study
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Yun-Sok Ha1, Jae-Wook Chung1, So Young Chun1, Seock Hwan Choi1, Jun Nyung Lee1, Bum Soo Kim1, Hyun Tae Kim1, Tae-Hwan Kim1, Seok-Soo Byun2, Eu Chang Hwang3, Seok Ho Kang4, Sung-Hoo Hong5, Jinsoo Chung6, Cheol Kwak7, Yong-June Kim8 and Tae Gyun Kwon1; KORCC study group
1 Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
2 Department of Urology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
3 Department of Urology, Chonnam National University Hwasun Hospital, Jeonnam, Korea
4 Department of Urology, Korea University School of Medicine, Seoul, Korea
5 Department of Urology, College of Medicine, The Catholic University of Korea, Seoul, Korea
6 Department of Urology, National Cancer Center, Goyang, Korea
7 Department of Urology, Seoul National University College of Medicine, Seoul, Korea
8 Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea
Tae Gyun Kwon, email:
Keywords: renal cell carcinoma; prognosis; thrombocytosis
Received: January 25, 2017 Accepted: March 03, 2017 Published: March 11, 2017
Background: The prognostic significance of preoperative thrombocytosis (TC) in renal cell carcinoma (RCC) is not without some debate. The aim of the present multi-institutional study was to determine the association of preoperative TC with the clinicopathological features and prognosis of localized RCC patients who underwent surgery in a large cohort.
Methods: A study involving 8 institutions, and 4,376 patients with pT1 and pT2 RCC from the Korean renal cell carcinoma (KORCC) database, was conducted. TC was defined as a platelet count ≥400,000/μL. Patients were divided into 2 groups based on the presence of preoperative TC. Clinicopathological variables and survival rates were compared between the 2 groups.
Results: Out of the 4,376 patients in the study, 106 (2.4%) had preoperative TC. Compared to patients without TC, these patients had a lower body mass index. Additionally, these patients had more advanced stage tumors with a higher Fuhrman grade, and higher incidence of symptoms at the time of diagnosis. Kaplan-Meier curves revealed that patients with TC had a significantly lower rate of recurrence-free survival (RFS). Furthermore, a lower rate of overall survival (OS) was exhibited amongst patients with TC. Multivariate analysis revealed that TC was an independent prognostic factor in terms of the RFS and OS.
Conclusions: TC appeared to be an important prognostic determinant in localized RCC. Furthermore, preoperative platelet count may be clinically useful for risk stratification of patients with surgically treated localized RCC.
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