Preoperative thrombocytopenia as a predictor of cancer-associated thromboembolism in gastric cancer patients undergoing gastrectomy

PurposeCancer-associated thromboembolism (CAT) is a major complication in gastric cancer, impacting patient outcomes. This study aimed to evaluate preoperative thrombocytopenia as a risk factor for CAT in gastric cancer patients undergoing gastrectomy.Materials and methodsA retrospective analysis wa...

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Main Authors: Moonki Jung, Song Ee Park, Jin Hwa Choi, Jeong Eun Kim, In Gyu Hwang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1585201/full
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author Moonki Jung
Song Ee Park
Jin Hwa Choi
Jin Hwa Choi
Jeong Eun Kim
In Gyu Hwang
In Gyu Hwang
author_facet Moonki Jung
Song Ee Park
Jin Hwa Choi
Jin Hwa Choi
Jeong Eun Kim
In Gyu Hwang
In Gyu Hwang
author_sort Moonki Jung
collection DOAJ
description PurposeCancer-associated thromboembolism (CAT) is a major complication in gastric cancer, impacting patient outcomes. This study aimed to evaluate preoperative thrombocytopenia as a risk factor for CAT in gastric cancer patients undergoing gastrectomy.Materials and methodsA retrospective analysis was conducted on 610 gastric cancer patients who underwent D2 gastrectomy between 2005 and 2017. The incidence of CAT and its association with preoperative thrombocytopenia, cancer stage, and recurrence were analyzed. Prognostic factors for CAT and survival were assessed using Kaplan-Meier analysis and Cox regression models.ResultsThe median follow-up was 67.0 months. Among the study participants, 5.7% (n=35) developed CAT. Preoperative thrombocytopenia was present in 71 patients (11.6%) and older age (≥65 years) was noted in 308 patients (50.1%). The 5-year incidence rate of CAT was 16.3% in patients with preoperative thrombocytopenia, compared to 4.8% in those with normal platelet counts. Patients with preoperative thrombocytopenia had a higher incidence of CAT compared to those with normal platelet counts (HR = 3.180, 95% CI 1.527-6.623, p = 0.002). Multivariate analysis revealed that thrombocytopenia (HR = 2.202, 95% CI 1.029-4.711, p = 0.042), older age (HR 2.484, 95% CI 1.166-5.290, p = 0.018), stage IV (HR = 2.966, 95% CI 1.106-8.466, p = 0.038) were independent poor prognostic factors for preoperative CAT in gastric cancer patients. Additionally, 29.7% of patients experienced cancer relapse, and 26.1% died during post-treatment follow-up. the patients who developed thromboembolisms had a significantly shorter 5-year OS rate compared with those who did not (56.6% vs. 76.1%, HR = 2.277, 95% CI = 1.376–3.767, p = 0.001).ConclusionsPreoperative thrombocytopenia is a significant predictor of CAT in gastric cancer patients. Along with advanced stage and older age, it increases thromboembolic risk and worsens survival. Further studies are needed to refine predictive models and optimize management strategies.
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spelling doaj-art-58bd6e056f8f41f68e7a2db02250595d2025-08-20T02:39:05ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-07-011510.3389/fonc.2025.15852011585201Preoperative thrombocytopenia as a predictor of cancer-associated thromboembolism in gastric cancer patients undergoing gastrectomyMoonki Jung0Song Ee Park1Jin Hwa Choi2Jin Hwa Choi3Jeong Eun Kim4In Gyu Hwang5In Gyu Hwang6Department of Internal Medicine, Chung-Ang University Gwang-myeong Hospital, Gwang-myeong, Republic of KoreaDivision of Medical Oncology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaChung-Ang University Integrated Oncology and Palliative Care Research Institute, Seoul, Republic of KoreaDepartment of Radiation Oncology, Chung-Ang University College of Medicine, Seoul, Republic of KoreaDepartment of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of KoreaChung-Ang University Integrated Oncology and Palliative Care Research Institute, Seoul, Republic of KoreaDepartment of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of KoreaPurposeCancer-associated thromboembolism (CAT) is a major complication in gastric cancer, impacting patient outcomes. This study aimed to evaluate preoperative thrombocytopenia as a risk factor for CAT in gastric cancer patients undergoing gastrectomy.Materials and methodsA retrospective analysis was conducted on 610 gastric cancer patients who underwent D2 gastrectomy between 2005 and 2017. The incidence of CAT and its association with preoperative thrombocytopenia, cancer stage, and recurrence were analyzed. Prognostic factors for CAT and survival were assessed using Kaplan-Meier analysis and Cox regression models.ResultsThe median follow-up was 67.0 months. Among the study participants, 5.7% (n=35) developed CAT. Preoperative thrombocytopenia was present in 71 patients (11.6%) and older age (≥65 years) was noted in 308 patients (50.1%). The 5-year incidence rate of CAT was 16.3% in patients with preoperative thrombocytopenia, compared to 4.8% in those with normal platelet counts. Patients with preoperative thrombocytopenia had a higher incidence of CAT compared to those with normal platelet counts (HR = 3.180, 95% CI 1.527-6.623, p = 0.002). Multivariate analysis revealed that thrombocytopenia (HR = 2.202, 95% CI 1.029-4.711, p = 0.042), older age (HR 2.484, 95% CI 1.166-5.290, p = 0.018), stage IV (HR = 2.966, 95% CI 1.106-8.466, p = 0.038) were independent poor prognostic factors for preoperative CAT in gastric cancer patients. Additionally, 29.7% of patients experienced cancer relapse, and 26.1% died during post-treatment follow-up. the patients who developed thromboembolisms had a significantly shorter 5-year OS rate compared with those who did not (56.6% vs. 76.1%, HR = 2.277, 95% CI = 1.376–3.767, p = 0.001).ConclusionsPreoperative thrombocytopenia is a significant predictor of CAT in gastric cancer patients. Along with advanced stage and older age, it increases thromboembolic risk and worsens survival. Further studies are needed to refine predictive models and optimize management strategies.https://www.frontiersin.org/articles/10.3389/fonc.2025.1585201/fullthrombocytopeniathromboembolismgastric cancergastrectomyprognosis
spellingShingle Moonki Jung
Song Ee Park
Jin Hwa Choi
Jin Hwa Choi
Jeong Eun Kim
In Gyu Hwang
In Gyu Hwang
Preoperative thrombocytopenia as a predictor of cancer-associated thromboembolism in gastric cancer patients undergoing gastrectomy
Frontiers in Oncology
thrombocytopenia
thromboembolism
gastric cancer
gastrectomy
prognosis
title Preoperative thrombocytopenia as a predictor of cancer-associated thromboembolism in gastric cancer patients undergoing gastrectomy
title_full Preoperative thrombocytopenia as a predictor of cancer-associated thromboembolism in gastric cancer patients undergoing gastrectomy
title_fullStr Preoperative thrombocytopenia as a predictor of cancer-associated thromboembolism in gastric cancer patients undergoing gastrectomy
title_full_unstemmed Preoperative thrombocytopenia as a predictor of cancer-associated thromboembolism in gastric cancer patients undergoing gastrectomy
title_short Preoperative thrombocytopenia as a predictor of cancer-associated thromboembolism in gastric cancer patients undergoing gastrectomy
title_sort preoperative thrombocytopenia as a predictor of cancer associated thromboembolism in gastric cancer patients undergoing gastrectomy
topic thrombocytopenia
thromboembolism
gastric cancer
gastrectomy
prognosis
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1585201/full
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