Objective To analyze the prognosis of hepatocellular carcinoma(HCC)patients with thrombocytosis(platelet count ≥350 × 109)after transcatheter arterial chemoembolization(TACE),and the effect of thrombocytosis on the prognosis of patients with HCC after TACE.Methods Clinical data of 867 patients with HCC admitted to the Department of Interventional Radiology,the Affiliated Hospital of Xuzhou Medical University from January 2013 to May 2018 were retrospectively analyzed.After propensity score matching,99 patients were enrolled,including 70 males and 29 females,aged(60.1±12.1)years.Patients were divided into the groups with thrombocytosis(n=33)and without thrombocytosis(n=66).The gender,maximum tumor diameter,Barcelona clinical liver cancer(BCLC)stage,and total bilirubin were compared between the two groups.The association of thrombocytosis with the prognosis of HCC after TACE treatment were analyzed using univariate and multivariate Cox regression.Results After propensity score matching,the male proportion,maximum tumor diameter,BCLC stage,and serum level of total bilirubin were comparable between the groups(all P＞0.05).Before TACE treatment,the platelet count of patients with thrombocytosis was(394.4±54.5)×109/L,which was higher than that after TACE[(278.2±86.4)× 109/L,t=7.63,P＜0.001].The progression-free survival rates after TACE in without thrombocytosis group were 83.3％,24.2％,and 7.6％at 3,6 and 9 months,respectively,better than those in thrombocy-tosis group(51.5％,3.0％,and 3.0％,respectively;x2=31.24,P＜0.001).The overall survival rates after TACE in without thrombocytosis group were 81.8％,30.3％,and 4.5％at 1,2 and 3 years,respec-tively,better than those in thrombocytosis group(15.2％,9.1％,and 3.0％,respectively;x2=27.89,P＜0.001).Multivariate Cox regression analysis showed that patients of HCC with thrombocytosis had an increased risk of tumor progression(HR=5.785,95％CI:3.291-10.168,P＜0.001)and increased risk of death(HR=4.090,95％CI:2.482-6.740,P＜0.001)after TACE.Conclusion The prognosis of TACE for HCC might be worse in patients with thrombocytosis.Thrombocytosis is a risk factor for cumulative survival and progression-free survival of HCC patients after TACE.
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