Lower circulating platelet counts and antiplatelet therapy independently predict better outcomes in patients with head and neck squamous cell carcinoma
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- 作者：Saleh Rachidi (1) (2)
Kristin Wallace (2) (3)
Terry A Day (2) (4)
Anthony J Alberg (2) (3)
Zihai Li (1) (2)
1. Department of Microbiology and Immunology ; 86 Jonathan Lucas ; Suite 612 ; Charleston ; SC ; 29425 ; USA
2. Hollings Cancer Center ; 86 Jonathan Lucas ; Suite 612 ; Charleston ; SC ; 29425 ; USA
3. Department of Public Health Sciences ; 68 President Street ; BE 103 ; Charleston ; SC ; 29425 ; USA
4. Head and Neck Tumor Center ; Department of Otolaryngology-Head and Neck Surgery ; Medical University of South Carolina ; 171 Ashley Avenue ; Charleston ; SC ; 29425 ; USA - 刊名：Journal of Hematology & Oncology
- 出版年：2014
- 出版时间：December 2014
- 年：2014
- 卷：7
- 期：1
- 全文大小：527 KB
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- 出版者：BioMed Central
- ISSN：1756-8722
文摘
Background Head and neck squamous cell carcinoma (HNSCC) mortality rates have not shown significant reduction in decades. Platelets are being implicated in having cancer-promoting roles, an observation supported by the adverse outcomes associated with thrombocytosis in many malignancies associated with thrombocytosis. However, the prognostic significance of platelet counts in HNSCC is unknown. Here, we comprehensively investigate the predictive value of platelet counts at diagnosis and post-diagnosis antiplatelet treatment in the overall survival of HNSCC patients. Methods The study population consists of 1051 pathologically confirmed HNSCC cases diagnosed between years 2000 and 2012 in a tertiary medical center. Platelet count was investigated as a predictor of survival by fitting Cox Proportional Hazards (CPH) regression models to generate Hazard Ratios (HR) and 95% confidence intervals (CI), while adjusting for age, sex, race, stage, treatment and smoking status. Finally, we evaluated the association between overall survival and antiplatelet medication intake after diagnosis. Results Multivariable analysis showed an increased death rate in patients with thromobocytosis [HR 2.37, 95% CI 1.60-3.50)] and high normal platelet counts [HR 2.20, 95% CI 1.58-3.05] compared to the reference middle normal group. Post-diagnosis treatment with antiplatelet medications was inversely associated with death rate [HR 0.76, 95% CI 0.58-0.99]. Conclusions Higher platelet counts were associated with poorer prognosis in HNSCC patients, whereas antiplatelet agents were associated with better prognosis. Antiplatelet agents warrant evaluation in preclinical and clinical settings as a way to improve survival in HNSCC.