Preoperative platelet count in esophageal squamous cell carcinoma: is it a prognostic factor?

Platelet count is inversely related to prognosis in many cancers; however, its role in esophageal cancer is still controversial. The purpose of this study was to determine the prognostic value of preoperative platelet count in esophageal squamous cell carcinoma (ESCC). From January 2006 to December 2008, a retrospective analysis of 425 consecutive patients with ESCC was conducted. A receiver operating characteristic (ROC) curve for survival prediction was plotted to verify the optimum cutoff point for preoperative platelet count. Univariate and multivariate analyses were performed to evaluate the prognostic parameters. A ROC curve for survival prediction was plotted to verify the optimum cutoff point for platelet count, which was 205 (x10(9)/L). Patients with platelet count a parts per thousand currency sign205 had a significantly better 5-year survival than patients with a platelet count > 205 (60.7 vs. 31.6 %, P < 0.001). The 5-year survival of patients either with platelet count a parts per thousand currency sign205 or > 205 were similar (68.6 vs. 58.8 %, P = 0.085) when the nodes were negative. However, the 5-year survival of patients with platelet count a parts per thousand currency sign205 was better than that of patients with a platelet count > 205 when the nodes were involved (32.0 vs. 12.7 %, P = 0.004). Multivariate analysis showed that platelet count (P = 0.013), T grade (P = 0.017), and N staging (P < 0.001) were independent prognostic factors. Preoperative platelet count is a predictive factor for long-term survival in ESCC, especially in nodal-positive patients. We conclude that 205 (x10(9)/L) may be the optimum cutoff point for platelet count in predicting survival in ESCC patients.