Significance of platelet count in esophageal carcinomas

Thrombocytosis is found to be associated with unfavorable prognosis in esophageal carcinoma. Platelets produce thymidine phosphorylase which is a platelet-derived endothelial cell growth factor with angiogenic activity. Increased platelet count may be translated into enhanced tumor growth. We examined the relation between platelet count and several prognostic variables in patients with esophageal cancer. Patients and Three hundred and eighty-one cases with esophageal cancer that underwent esophagectomy in a referral cancer institute during a 5-year period were studied retrospectively. The relation between preoperative platelet count and patient age, gender, site of tumor, presence of multiple cancers and clinicopathological characteristics including histological type, tumor size, depth of penetration [T], lymph node involvement [N], distant metastasis [M], degree of differentiation, presence of vascular, lymphatic and perineural invasion was examined. Squamous cell carcinoma [SCC] constituted 93% and adenocarcinoma 7% of cases. Most of patients were in stage III, followed by stage II. The mean platelet count was 245 +/- 76 [10[9]/L]. There was no statistically significant correlation between platelet counts with prognostic factors except a weak linear correlation between platelet count and and tumor size [P= 0.03, Pearson correlation coefficient: 0.16]. Patients with adenocarcinoma had a higher platelet count than those with SCC [P= 0.003]. Platelet count does not correlate with prognostic factors in esophageal cancer. However, it is significantly different between SCC and adenocarcinoma of esophagus

effect of age on the outcome of esophageal cancer surgery

Surgery is still the best way for treatment of esophageal cancer. The increase in life expectancy and the rising incidence of esophageal tumors have led to a great number of elderly candidates for complex surgery. The purpose of this study was to evaluate the effects of advanced age [70 years or more] on the surgical outcome of esophagectomy for esophageal cancer at a single high-volume center. Between January 2000 and April 2006, 480 cases with esophageal cancer underwent esophagectomy in the referral cancer institute. One hundred sixty-five patients in the elderly group [70 years old or more] were compared with 315 patients in the younger group [<70 years]. All in-hospital morbidity and mortality were studied. The range of age was 38-84 years, with a mean of 58.7. The mean age of the elderly and younger groups was 74 and 53.2, respectively. In the younger group, 70 patients [22.2%] and in the elderly group, 39 patients [23.6%] were complicated [P 0.72].The most common complications in the two groups were pulmonary complications [9.8% in younger and 10.3% in elderly] [P 0.87]. Rates of anastomotic leakage and cardiac complications were also similar between the two groups. Hospital mortality rates in younger and elderly patients were 2.8% and 3%, respectively. There was no significant difference between the two groups in morbidities and mortality [P -value > 0.05]. With increased experience and care, the outcomes of esophagectomy in elderly patients are comparable to young patients. Advanced age alone is not a contraindication for esophagectomy