Preoperative mean platelet volume predicts survival in breast cancer patients with type 2 diabetes

Preoperative platelet distribution width predicts bone metastasis in patients with breast cancer

PURPOSE

Bone metastases occur in 50-70% of patients with breast cancer (BC) and result in high mortality. Platelet distribution width (PDW), a commonly used parameter of activated platelets, has been associated with a poor prognosis in BC. We aim to investigate the prognostic role of PDW for bone metastasis in BC patients.

METHODS

515 patients who received BC surgery in the Harbin Medical University Cancer Hospital from July 1, 2016, to December 31, 2017, were reviewed. Patients' characteristics and platelet indices upon enrollment in this study were collected. The Kaplan-Meier method was used to estimate the 5-year bone metastasis incidence. The univariate and multivariate Cox regression analyses were utilized to identify risk factors associated with bone metastasis.

RESULTS

The patients with bone metastases exhibited lower PDW levels than the patients without bone metastases. Moreover, decreased PDW was significantly correlated with histologic type, multifocal disease, and lymph node status. In addition, the patients with reduced PDW levels were more likely to develop bone metastasis. Multivariate analysis showed that PDW was an independent predictor for bone metastasis.

CONCLUSION

PDW is an independent predictor of bone metastasis in BC. Further research is warranted.

A prognostic nomogram that includes MPV in esophageal squamous cell carcinoma

BACKGROUND

Mean platelet volume (MPV), as a marker of platelet activity, has been shown to be an efficient prognostic biomarker in several types of cancer. Using MPV, this study aimed to create and validate a prognostic nomogram to the overall survival in esophageal squamous cell carcinoma (ESCC) patients.

METHODS

The nomogram was constructed and tested using data from a retrospective study of 1893 patients who were randomly assigned to the training and testing cohorts with a 7:3 randomization. In order to screen out the optimal predictors for overall survival (OS), we conducted the LASSO-cox regression, univariate, and multivariate cox regression analyses. Subsequently, the predictive accuracy of the nomogram was validated in both the training and the testing cohorts. Finally, decision curve analysis (DCA) was used to confirm clinical validity.

RESULTS

Age, MPV, nerve invasion, T stage, and N stage were found as independent prognostic variables for OS and were further developed into a nomogram. The nomogram's prediction accuracy for 1-, 3-, and 5-year OS was 0.736, 0.749, 0.774, and 0.724, 0.719, 0.704 in the training and testing cohorts, respectively. Furthermore, DCA results indicated that nomograms outperformed the AJCC 8th and conventional T, N staging systems in both the training and testing cohorts.

CONCLUSIONS

The nomogram, in conjunction with MPV and standard clinicopathological markers, could improve the accuracy of prediction of OS in ESCC patients.

Prognostic role of preoperative circulating systemic inflammatory response markers in primary breast cancer: meta-analysis

BACKGROUND

Circulating markers of the systemic inflammatory response are prognostic in several cancers, but their role in operable breast cancer is unclear. A systematic review and meta-analysis of the literature was carried out.

METHODS

A search of electronic databases up to August 2020 identified studies that examined the prognostic value of preoperative circulating markers of the systemic inflammatory response in primary operable breast cancer. A meta-analysis was carried out for each marker with more than three studies, reporting a HR and 95 per cent confidence interval for disease-free survival (DFS), breast cancer-specific survival (BCSS) or overall survival (OS).

RESULTS

In total, 57 studies were reviewed and 42 were suitable for meta-analysis. Higher neutrophil-to-lymphocyte ratio (NLR) was associated with worse overall survival (OS) (pooled HR 1.75, 95 per cent c.i. 1.52 to 2.00; P < 0.001), disease-free survival (DFS) (HR 1.67, 1.50 to 1.87; P < 0.001), and breast cancer-specific survival (BCSS) (HR 1.89, 1.35 to 2.63; P < 0.001). This effect was also seen with an arithmetically-derived NLR (dNLR). Higher platelet-to-lymphocyte ratio (PLR) was associated with worse OS (HR 1.29, 1.10 to 1.50; P = 0.001) and DFS (HR 1.58, 1.33 to 1.88; P < 0.001). Higher lymphocyte-to-monocyte ratio (LMR) was associated with improved DFS (HR 0.65, 0.51 to 0.82; P < 0.001), and higher C-reactive protein (CRP) level was associated with worse BCSS (HR 1.22, 1.07 to 1.39; P = 0.002) and OS (HR 1.24, 1.14 to 1.35; P = 0.002).

CONCLUSION

Current evidence suggests a role for preoperative NLR, dNLR, LMR, PLR, and CRP as prognostic markers in primary operable breast cancer. Further work should define their role in clinical practice, particularly reproducible thresholds and molecular subtypes for which these may be of most value.

Prognostic and clinicopathological significance of pretreatment mean platelet volume in cancer: a meta-analysis

OBJECTIVE

Our study aimed to evaluate the prognostic and clinicopathological significance of pretreatment mean platelet volume (MPV) on cancer by using meta-analysis of published studies.

DESIGN

Meta-analysis.

DATA SOURCES

Relevant studies available before 22 December 2019 were identified by searching MEDLINE, EMBASE.

ELIGIBILITY CRITERIA

All published studies that assessed the prognostic and clinicopathological significance of pretreatment MPV on cancer were included.

DATA EXTRACTION AND SYNTHESIS

Studies were identified and extracted by two reviewers independently. The HR/OR and its 95% CIs of survival outcomes and clinicopathological parameters were calculated.

RESULTS

A total of 38 eligible studies (41 subsets) with 9894 patients with cancer were included in the final meta-analysis. MPV level was not significantly associated with both overall survival (HR 0.98, 95% CI 0.84 to 1.14) and disease-free survival (HR 1.22, 95% CI 0.86 to 1.73) of patients with cancer. Neither advanced nor mixed-stage tumour patients showed significant association between MPV and overall survival (HR 1.36, 95% CI 0.96 to 1.94, HR 0.90, 95% CI 0.74 to 1.09). However, high MPV had the strongest relationship with poor overall survival (HR 2.01; 95% CI 1.08 to 3.41) in gastric cancer, followed by pancreatic cancer (HR 1.54; 95% CI 1.31 to 1.82). Whereas in the subgroup using receiver operating characteristic curve method to define cut-off values, low MPV was significantly related to poor overall survival (HR 0.78, 95% CI 0.64 to 0.95). In addition, MPV had no significant association with age (OR 0.96, 95% CI 0.90 to 1.02), sex (OR 1.04, 95% CI 1.00 to 1.09), depth of cancer invasion (OR 0.90, 95% CI 0.77 to 1.04) and tumour stage (OR 0.91, 95% CI 0.78 to 1.07).

CONCLUSIONS

Pretreatment MPV level is of no clearly prognostic significance in cancers and no significant association with clinicopathological parameters of patients with cancers.