Prognostic implication of dynamic platelet count in lung cancer patients with thrombocytosis: a retrospective...

Thrombocytosis is associated with poor prognosis in lung cancer patients. However, no studies have further assessed the effect of platelet-related parameters on the prognosis among lung cancer patients with thrombocytosis.

Between 2020 and 2021, lung cancer patients with a platelet count ≥ 300 *10⁹/L or normal count were retrospectively reviewed. Potential prognostic factors were identified using univariate and multivariate accelerate failure time (AFT) model. Kaplan-Meier method and log-rank test were used to compare survival outcome.

Among patients with thrombocytosis (N = 148), time point of platelet elevation, platelet distribution width (PDW), platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) did not significantly impact first-line progression-free survival (PFS). Compared to patients whose platelet count normalized after treatment, patients with sustained platelet elevation exhibited a worst PFS (β =  - 1.291, p < 0.001), and although patients with fluctuant platelet elevation had worse PFS (β =  - 0.358, p = 0.054), the difference was not statistically significant. Additionally, mean platelet volume (MPV) (β = 0.319, p = 0.008) and D-dimer (β =  - 0.046, p = 0.025) were also factors affecting first-line PFS.

Among platelet-related parameters, besides MPV and D-dimer, the dynamic pattern of platelet count serves as a prognostic marker in lung cancer patients with thrombocytosis.