Abstract 94P
Background
Mean platelet volume (MPV) is a marker of inflammation that indicates the average size of platelets, platelet production rate and stimulation. The role of Pre-operative levels of MPV and its prognostic effect on disease free survival (DFS) and overall survival (OS) are poorly understood. This study was intended to analyze the effect of pre-operative levels of MPV on DFS and OS of stage III rectal cancer patients.
Methods
This is a retrospective study of 149 stage III rectal cancer patients who underwent surgery in our institution between 2011 and 2015. Association between pre-operative levels of MPV and clinicopathological variables were analysed. DFS and OS for 5 years were analysed, and survival analysis was done using Kaplan-Meier curve. MPV of 9.35 femto litres (fl) was chosen based on the ROC curve. The Area under curve was 0.889. Differences between survival curves were analysed for statistical significance using log-rank test.
Results
In our study, mean 5-year OS were 91.1 and 50.36 months, for patients with MPV < 9.35 and MPV >9.35 respectively (P 0.0001). The mean DFS of MPV < 9.35 and MPV > 9.35 were 89.32 and 43.54 months respectively (P 0.0001). Univariate analysis for OS and DFS showed significance for MPV, Nodal status, Circumferential resection margin, stage and lymph node ratio. Multivariate analysis showed significance for MPV [HR 2.379 (95% CI 1.733-3.264) P .0001 for MPV>9.35] and CRM [HR 0.392 (95% CI 0.191-0.804) P 0.01) for CRM negative] for OS and DFS. Multivariate Analysis for OS & DFS Table: 94P
Variable | OS | DFS | ||||||
P value | Hazard Ratio | 95% CI | P value | Hazard Ratio | 95% CI | |||
Lower | Upper | Lower | Upper | |||||
N Stage | ||||||||
N1a | .782 | .785 | .140 | 4.390 | .824 | .833 | .167 | 4.146 |
N1b | .119 | .322 | .077 | 1.340 | .159 | .389 | .104 | 1.448 |
N2a | .554 | .715 | .235 | 2.175 | .680 | .810 | .297 | 2.209 |
N2b | Reference | Reference | ||||||
CRM | ||||||||
Negative | .011 | .392 | .191 | .804 | .012 | .412 | .207 | .821 |
Positive | Reference | Reference | ||||||
Stage | ||||||||
IIIA | .568 | .692 | .196 | 2.447 | .203 | .465 | .143 | 1.510 |
IIIB | .474 | .727 | .303 | 1.743 | .203 | .607 | .281 | 1.310 |
IIIC | Reference | Reference | ||||||
MPV | ||||||||
>9.35 | .0001 | 2.379 | 1.733 | 3.264 | .0001 | 2.370 | 1.791 | 3.136 |
<9.35 | Reference | Reference | ||||||
LNR ratio | ||||||||
>0.2 | .220 | 3.269 | .492 | 21.738 | .059 | 5.756 | .938 | 35.327 |
<0.2 | Reference | Reference |
Conclusions
Pre-operative MPV measured one week before surgery is a convenient and inexpensive marker which has been proved to be a prognostic marker for OS and DFS in stage III rectal cancer patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Kidwai Memorial Institute of Oncology, Bangalore, India.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
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