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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

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1437-4331
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Volume 57, Issue 5

Issues

Large platelet size is associated with poor outcome in patients with metastatic pancreatic cancer

Anna L. Lembeck
  • Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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/ Florian Posch
  • Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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/ Eva V. Klocker
  • Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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/ Joanna Szkandera
  • Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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/ Konstantin Schlick
  • 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria
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/ Tatjana Stojakovic
  • Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
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/ Peter Kornprat / Caroline Lackner / Armin Gerger
  • Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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/ Herbert Stoeger
  • Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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/ Michael Stotz
  • Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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/ Martin Pichler
  • Corresponding author
  • Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
  • Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA, Phone: +43.316.385.81320, Fax: +43.316.385.14167
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Published Online: 2018-10-11 | DOI: https://doi.org/10.1515/cclm-2018-0016

Abstract

Background

Platelets are a major cellular component of blood and their interaction with cancer cells is well-established to influence cancer progression and metastases. The physical size of platelets may have a critical impact on the interaction with cancer cells. In this study, we explored the potential prognostic role of platelet size measured by the determination of the mean platetlet volume (MPV) in patients with pancreatic ductal adenocarcinoma (PDAC).

Methods

Data from 527 patients with PDAC diagnosed and treated between 2004 and 2015 at a single center were evaluated retrospectively. Associations between MPV and baseline covariates were assessed with Wilcoxon’s rank-sum tests, χ2-tests, and Fisher’s exact tests. Median follow-up was estimated with a reverse Kaplan-Meier estimator according to Schemper and Smith. Analysis of time-to-death was performed with Kaplan-Meier estimators, log-rank tests and uni- and multivariable Cox proportional hazards models.

Results

The median MPV was 10.5 femto liter (fL) [9.8–11.3], ranged from 5.9 to 17.7 fL. A large platelet volume was associated with high-grade G3/4 tumors (p=0.004) and worse overall survival (OS) in patients with metastatic disease in univariable analysis (hazard ratio [HR] per fL increase in MPV=1.13 [95% CI: 1.04–1.23, p=0.005]). In multivariable analysis of metatatic PDAC patients, the adverse association between large platelets and a higher risk-of-death prevailed (adjusted HR per doubling of MPV=2.00; 95% CI: 1.10–3.62, p=0.02).

Conclusions

Large platelets represent a negative prognostic factor and add an independent prognostic information to well-established factors in PDAC patients. MPV should be considered for future individual risk assessment in patients with stage IV PDAC.

This article offers supplementary material which is provided at the end of the article.

Keywords: mean platelet volume; metastatic pancreatic cancer; prognosis

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About the article

Corresponding author: Martin Pichler, MD, Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria


Received: 2018-01-06

Accepted: 2018-09-19

Published Online: 2018-10-11

Published in Print: 2019-04-24


Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 57, Issue 5, Pages 740–744, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2018-0016.

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