Prognostic Significance of Preoperative Thrombocytosis in Patients with Endometrial Carcinoma: Our Experience and Review of the Literature

Objective: In this study, we aimed to determine the prevalence and prognostic significance of preoperative thrombocytosis (defined as platelet count ≥ 400 × 103/μl) in patients with endometrial carcinoma. Methods: This was a retrospective analysis of 389 consecutive patients diagnosed and treated at our Institution with endometrial carcinoma between 2004 and 2014. The clinicopathological characteristics of the patients (age, race, tumor type, AJCC stage, and preoperative hematological parameters) were recorded. Survival data were provided by the tumor registry. Results: The mean age of the study population was 63.7 years at diagnosis (range=33 to 97 years), and the majority (n=350, 90%) of patients were Caucasian. Most patients (n=292, 75.1%) were diagnosed with Stage I endometrial carcinoma. In addition, seventeen patients (4.4%) had Stage II, 49 patients (12.6%) had Stage III, and 9 patients (2.3%) had Stage IV disease. The most common type of cancer (n=269, 69.2%) was endometrioid adenocarcinoma, followed by mixed cell (n=16, 4.1%) and serous (n=11, 2.8%) carcinoma, respectively. A small subset (n=24, 6.2%) of the patients had thrombocytosis at diagnosis. The prevalence of thrombocytosis increased with the stage, for example from 4.5% in Stage I to 17.6% Stage II carcinoma. Interestingly, thrombocytosis appeared to be more common in African American patients (30.8%) than in Caucasians (5.4%). Statistical analysis of the survival data revealed an adverse prognostic significance for thrombocytosis: patients with thrombocytosis died at a younger age (64.3 years) than did those with normal platelet count (74.5 years). Conclusion: Thrombocytosis at diagnosis portends adverse prognostic significance in patients with endometrial carcinoma. Elevated platelet count seems to associate with higher stage disease and shorter survival. Thrombocytosis may serve as an independent prognostic factor in endometrial carcinoma or a surrogate marker for high stage disease.