- Patients with small-cell lung cancer (SCLC) and no brain metastases at diagnosis who have high pretreatment platelet counts have a higher risk for brain metastases, suggesting platelet counts could be used to identify which patients may be most likely to have disease progression in the brain.
Why this matters
- A higher 2-year OS among patients with SCLC, made possible by treatment advances, requires greater vigilance in monitoring for disease recurrence, particularly in the brain.
- 293 patients with SCLC and no brain metastases and pretreatment complete blood counts.
- Funding: National Institutes of Health.
- Overall, 39% developed brain metastases.
- Brain metastases were more common among patients with high platelet counts (>270 x 109/L) compared with those with low platelet counts (≤270 x 109/L, 46% vs 32%; Log-rank P=.009).
- 2-year brain metastasis-free survival (BMFS) rate was significantly worse for patients with high platelet counts compared with those with low counts (14.6% vs 22.1%; P=.009) and for those with high platelet-to-lymphocyte ratio (PLR, 15.9% for >119.4 vs 25.4% for ≤119.4; P=.022).
- After multivariable analysis, high pretreatment platelet count was independently associated with worse BMFS (HR, 1.516; 95% CI, 1.024-2.245; P=.038), but high PLR was not.
- Single-center, retrospective analysis.