학술논문

Platelets as a prognostic factor for patients with adenocarcinoma of the gastroesophageal junction
Document Type
Original Paper
Source
Langenbeck's Archives of Surgery. 408(1)
Subject
Adenocarcinomas of the esophagogastric junction
Neoadjuvant treatment
Primary resection
Mean platelet volume
Platelet count
Language
English
ISSN
1435-2451
Abstract
Objective: The aim of this study was to investigate the prognostic role of plasma platelet count (PLT), mean platelet volume (MPV), and the combined COP-MPV score in patients with resectable adenocarcinomas of the gastroesophageal junction.Background: Platelet activation, quantified by PLT and elevated MPV, plays an essential part in the biological process of carcinogenesis and metastasis. An increased preoperative COP-MPV is associated with poor survival in various tumor entities.Methods: Data of 265 patients undergoing surgical resection for adenocarcinoma of the gastroesophageal junction were abstracted. COP-MPV score was defined for each patient. Utilizing univariate and multivariate Cox proportional hazard analyses, survival was determined.Results: In univariate analysis, elevated PLT (HR 3.58, 95% CI 2.61–4.80, p<0.001) and increased COP-MPV (HR 0.27, 95% CI 0.17–0.42, p<0.001 and HR 0.42, 95% CI 0.29–0.60, p<0.001) significantly correlated with shorter patients’ overall and disease-free survival, for all 256 patients, as well as in the subgroups of neoadjuvantly treated (p<0.001) and primarily resected patients (p<0.001). COP-MPV remained a significant prognostic factor in multivariate analysis for OS. However, PLT alone showed significant diminished OS and DFS in all subgroups (p<0.001) in univariate and multivariate analysis.Conclusion: PLT is a potent independent prognostic biomarker for survival in a large prospective cohort of patients with resectable adenocarcinoma of the gastroesophageal junction. Additionally, we confirm that the COP-MPV score is significantly associated with worse outcome in these patients, but has no benefit in comparison to PLT.