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Oncotarget. 2017 Apr 11;8(15):24327-24336. doi: 10.18632/oncotarget.15358.

The association of pretreatment thrombocytosis with prognosis and clinicopathological significance in cervical cancer: a systematic review and meta-analysis.

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Department of Gynecology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, P.R. China.
Reproductive Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, Guangdong Province, P.R. China.
Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, P.R. China.
Department of nephrology, The Second Xiangya Hospital, Central South University, Changsha 410001, Hunan Province, P.R. China.


Previous studies reported inconsistent findings about the relationship between pretreatment thrombocytosis and survival in patients with cervical cancer. This study aimed to evaluate the prognostic significance of thrombocytosis in cervical cancer. We searched databases to identify relevant articles. Pooled hazard ratios (HRs), odds ratios (ORs), and 95% confidence intervals (CIs) were calculated. Fourteen studies including 3,394 patients were eligible for the meta-analysis. Overall, an elevated platelet count was significantly associated with inferior overall survival (OS, hazard ratio [HR]: 1.66, 95% confidence interval [CI]: 1.42-1.95, P < 0.001) and recurrence-free survival (RFS, HR: 1.67, 95% CI: 1.15-2.42, P = 0.007) but not progression-free survival (PFS, HR: 1.21, 95% CI: 0.89-1.64; P = 0.235). The results were similar for low stage patients treated with surgery alone. Moreover, a pretreatment thrombocytosis status was significantly associated with higher clinical stage (odd ratio [OR]: 2.39, 95% CI: 1.68-3.38, P < 0.001), positive pelvic node status (OR: 1.58, 95% CI: 1.01- 2.45, P = 0.044) and larger tumor size (OR: 2.32, 95% CI: 1.39-3.87, P = 0.001). Pretreatment thrombocytosis is an independent prognosis predictor in cervical cancer patients. It may be used as a readily available biomarker to refine clinical outcome prediction for cervical cancer patients.


cervical cancer; inflammation; meta-analysis; prognosis; thrombocytosis

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