High platelet count predicts poor prognosis in HCC patients undergoing TACE: a propensity score-matched analysis

ABSTRACT

Background

The aim of this study was to retrospectively evaluate the prognostic value of the pretreatment platelet (PLT) count in patients with hepatitis B virus (HBV)-related intermediate-advanced hepatocellular carcinoma (HCC) complicated with cirrhosis undergoing transcatheter arterial chemoembolization (TACE).

Research Design and Methods

We assessed 362 patients with HBV-related intermediate-advanced HCC complicated with cirrhosis undergoing TACE. Patients were divided into low (≤96 × 10⁹/L) and high (>96 × 10⁹/L) PLT groups. Propensity score matching (PSM) was performed to eliminate the imbalance in potential confounding factors. The endpoint was time to progression (TTP).

Results

After PSM, the high and low PLT groups had 97 patients each. The TTP was significantly longer in the low PLT group than in the high PLT group (log-rank test, p < 0.001). A high pretreatment PLT count was an independent predictor of poor tumor response (OR 4.724; 95% CI 1.889–11.815; P = 0.001) and short TTP (HR = 3.598; 95% CI: 2.570–5.036; P < 0.001). Subgroup analysis showed that a high PLT count increased the risk of progression across almost all subgroups.

Conclusions

The pretreatment PLT count has potential value in predicting the prognosis of patients with intermediate-advanced HCC undergoing TACE.

KEYWORDS:

• Chemoembolization
• cirrhosis
• hepatocellular carcinoma
• platelet
• propensity score

Acknowledgments

The authors thank Zi-Jie Miao, Chang-Hong Wu and Kun-Lin Wu for their technical support.

Declaration of interests

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in this manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Conceptualization: Si-Peng Li, Yue Li. Methodology: Si-Peng Li, Jia-Hui He, Ming-Geng Lou. Data collection and analysis: Si-Peng Li, Jia-Hui He, Ming-Geng Lou, Xin-Xin Tu. Software: Si-Peng Li, Jia-Hui He, Ming-Geng Lou, Xin-Xin Tu, Ding Cao. Writing – original draft: Si-Peng Li. Writing – review & editing: Si-Peng Li, Ding Cao, Yue Li.

Availability of data and materials

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

Ethics approval and consent to participate

Our investigation was carried out according to the Declaration of Helsinki. The study accords with the ethics of the Second Affiliated Hospital of Chongqing Medical University. Written informed consent was obtained from all patients.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This work was supported by grants from Natural Science Foundation of Chongqing (No: cstc2020jcyj-msxm0631).