THROMBOCYTOSIS IN SURGICALLY TREATED STAGE-IB SQUAMOUS-CELL CERVICAL-CARCINOMA (A GYNECOLOGIC-ONCOLOGY-GROUP STUDY)

Thrombocytosis has previously been shown to be an unfavorable prognost ic factor in cervical cancer patients treated with irradiation. We eva luated the significance of thrombocytosis (platelet count >400 x 10(9) /liter in 623 surgically treated patients with stage IB squamous cell carcinoma of the cervix. These patients had no gross evidence of extra uterine disease at the time of exploration, and none had metastasis to the paraaortic nodes. Fifty-nine (9.5%) of these 623 patients had thr ombocytosis. The 5-year survival for patients with thrombocytosis was 82% compared to 83.5% for patients with normal platelet count (P = 0.4 ). Pelvic node metastasis was present in 13 (22%) of 59 patients with thrombocytosis, and 77 (13.7%) of 564 patients with normal platelet co unt (P = 0.1). There was a significant correlation between tumor size and platelet count. Patients with thrombocytosis had a mean tumor size of 27.9 mm, while it was 20.4 mm in patients without thrombocytosis ( P = 0.002). Other factors found to be associated with thrombocytosis i n this population were elevated white blood cell (WBC) count (P = 0.00 9) and history of chronic obstructive pulmonary disease (COPD) (P = 0. 02). In a multivariate analysis for thrombocytosis adjusted for COPD, WBC count, and tumor size, tumor size continued to be statistically si gnificant (P = 0.01). These data suggest that thrombocytosis is a mark er of tumor burden and not an independent prognostic factor for progre ssion-free interval or survival. (C) 1994 Academic Press, Inc.