Preoperative Elevated Platelet Count as a Prognostic Factor in Vulvar Squamous Cell Cancer: A Mini-review

Preoperative thrombocytosis has been shown to be a marker of advanced disease and poor survival in gynecologic malignancies, specifically endometrial, ovarian, and cervical cancers. The aim of this study is to provide a focused mini-review on all the existing literature concerning the role of preoperative thrombocytosis as a prognostic factor in vulvar squamous cell cancer (SCC). A PubMed search (until February 20, 2018) of all peer-reviewed and English-published articles was conducted using the following keywords: platelet, thrombocytosis, and vulvar cancer. Only three studies met the search protocol. It is concluded that preoperative thrombocytosis does not emerge as a substantial independent prognostic factor of disease-free survival (DFS) and overall survival (OS) in patients with vulvar SCC. Nevertheless, the interpretation of this conclusion should be done with extreme cautiousness. This can be ascribed to the heterogeneity of the reported data across the three studies, especially concerns pertaining to methodological designs. Additional related uniform studies are needed, so that data can be usefully pooled into a well-characterized systematic review/meta-analysis study, in order to devise valid mathematically proven conclusions. For now, International Federation of Gynecology and Obstetrics/ Fédération Internationale de Gynécologie et d'Obstétrique staging (FIGO staging) and inguino-femoral lymph node involvement continue to be the most established independent prognostic factors of DFS and OS in patients with vulvar SCC.