Pretreatment Platelet Count and Prognosis in Pancreatic Cancer Patients: A Meta-Analysis

Objective To clarify the role of platelet count in predicting the prognosis of pancreatic cancer patients through summarizing the current evidences by meta-analysis. Methods The PubMed, EMBASE, Cochrane library, CNKI, WANFANG, and VIP database were searched for studies investigating the relationship between platelet count and pancreatic cancer prognosis. The Newcastle-Ottawa scale was used to evaluate the quality of the literatures. Meta-analysis was performed using RevMan 5.3 software to analyze the prognostic value of platelet counts using the hazard ratio （HR） and 95% confidence intervals （95%CI）. Results A total of 15 studies including 2 420 patients were included. The pooled HR of 1.38（95%CI 1.11~1.71,P=0.004）showed that patients with elevated platelet counts were expected to have poor overall survival （OS）. Pooled of 11 studies using multivariate analysis revealed a HR of 1.67（95%CI 1.26~2.23, P=0.000 4）, suggesting elevated pretreatment platelet count was an adverse prognosis factor for pancreatic cancer patients. Subgroup analysis showed that prognostic value of platelet level was stronger in patient those received surgical resection（HR=2.19, 95%CI 1.59~3.02,P<0.000 1） followed by in patient received palliative therapy （HR=1.63,95%CI 1.12~2.36,P=0.01）; additionally, in patients without metastasis the increased platelet count was significantly associated with decreased OS （HR=1.61, 95%CI 1.18~2.20,P=0.003）, but not in patients with metastasis （HR=1.15,95%CI 0.75~1.76, P=0.51）. Conclusion Pretreatment platelet count is a prognosis factor in patients with pancreatic cancer. Patients with elevated platelet count may have decreased OS, especially for those received surgical resection.