Prognostic significance of pretreatment elevated platelet count in patients with colorectal cancer: a meta-analysis

BACKGROUND: The prognostic effect of pretreatment elevated platelet count remains controversial in colorectal cancer patients. We conducted this meta-analysis to evaluate the prognostic impact of it in these patients. METHODS: PubMed, EMBASE and Cochrane Library were searched and studies on the prognostic significance of pretreatment elevated platelet count in colorectal patients were identified. We performed the meta-analysis, using overall survival and disease-free survival as outcomes and presenting data with hazard ratio and its 95% confidence interval. Heterogeneity among studies and publication bias were also evaluated. RESULTS: Thirty studies were included in the meta-analysis. Compared with normal platelet count, pretreatment elevated platelet count was associated with poorer overall survival (Hazard ratio = 1.837, 95% confidence interval, 1.497 to 2.255, p = 0.000) and poorer disease-free survival (Hazard ratio = 1.635, 95% confidence interval, 1.237 to 2.160, p = 0.001) in patients with colorectal cancer. In subgroup analyses, pretreatment elevated platelet count was also associated with poorer overall survival and disease-free survival in most subgroups. CONCLUSION: Pretreatment elevated platelet count was an independent prognostic factor of overall survival and disease-free survival in colorectal cancer patients. Large-scale prospective studies and a validation study are warranted.