Preoperative platelet count as an independent predictor of long‐term outcomes among patients undergoing resection for intrahepatic cholangiocarcinoma

Abstract

AbstractBackground and ObjectivesAn elevated platelet count may reflect neoplastic and inflammatory states, with cytokine‐driven overproduction of platelets. The objective of this study was to evaluate the prognostic utility of high platelet count among patients undergoing curative‐intent liver surgery for intrahepatic cholangiocarcinoma (ICC).MethodsAn international, multi‐institutional cohort was used to identify patients undergoing curative‐intent liver resection for ICC (2000–2020). A high platelet count was defined as platelets >300 *109/L. The relationship between preoperative platelet count, cancer‐specific survival (CSS), and overall survival (OS) was examined.ResultsAmong 825 patients undergoing curative‐intent resection for ICC, 139 had a high platelet count, which correlated with multifocal disease, lymph nodes metastasis, poor to undifferentiated grade, and microvascular invasion. Patients with high platelet counts had worse 5‐year (35.8% vs. 46.7%, p = 0.009) CSS and OS (24.8% vs. 39.8%, p < 0.001), relative to patients with a low platelet count. After controlling for relevant clinicopathologic factors, high platelet count remained an adverse independent predictor of CSS (HR = 1.46, 95% CI 1.02–2.09) and OS (HR = 1.59, 95% CI 1.14–2.22).ConclusionsHigh platelet count was associated with worse tumor characteristics and poor long‐term CSS and OS. Platelet count represents a readily‐available laboratory value that may preoperatively improve risk‐stratification of patients undergoing curative‐intent liver resection for ICC.