ArticleJournal of hepatocellular carcinoma2025
Prognostic Significance of Elevated Platelet Count (>200 x 10^9 per L) in BCLC Stages B and C of Hepatocellular Carcinoma: A Retrospective Multicenter Analysis.
Article in Journal of hepatocellular carcinoma, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Anti-Metastatic Role of Aspirin in Cancer: A Systematic Review.International journal of molecular sciences · 2026Pooled it
- Platelet count as a prognostic biomarker in resected hepatocellular carcinoma: differential impact of thrombocytosis and thrombocytopenia by btiology and fibrosis.Surgery today · 2026Article
- The role of platelets in the hepatocellular carcinoma immune microenvironment and their clinical prospects: a comprehensive review.Medical oncology (Northwood, London, England) · 2026Review
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Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: In hepatocellular carcinoma (HCC) comorbidities related to decreased liver function or to portal hypertension often limit treatment options. Traditionally, low platelet count has been considered a negative prognostic factor in HCC, especially in early stages. However, recent evidence suggests that elevated platelet count may also predict worse outcomes in advanced stages, suggesting a stage-dependent prognostic impact. Aim: This study evaluated the prognostic role of platelet counts across BCLC stages, adjusted for portal hypertension, to improve individualized patient management. Methods: In this retrospective, multicenter study, platelet count of 1112 patients with HCC in different tumor stages was analyzed. Various platelet count cutoffs (X to Y × 10^9/L) were tested to identify the optimal prognostic threshold. To isolate the effect of platelet levels from portal hypertension, spleen diameter was incorporated as an adjustment variable in multivariate analyses, with variceal status considered when available (in about two thirds of patients). Using an optimized cut-off, survival analysis was performed using univariate and multivariate Cox proportional hazards models. Bootstrapping was performed for internal validation. Results: Platelet count outside 84-200 × 10^9/L was associated with poorer survival (HR = 0.66, 95% CI = 0.57-0.78, p < 0.0001). Bootstrapping showed robustness of the final model. Subgroup analysis revealed worse survival in BCLC stages B and C but not stage A for elevated platelet counts (>200 × 10^9/L) in multivariate analysis (including spleen diameter). Conclusion: Platelet counts showed a stage-dependent prognostic impact in HCC. A platelet count above a cutoff of 200/µL at diagnosis was associated with poorer prognosis. Using this cutoff may improve survival prediction in BCLC B and C patients with potential usage for risk stratification and guidance of treatment decisions. Further external validation is required to confirm these findings and evaluate their clinical applicability.
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