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Peer-reviewedCC BYScientific Reports

Lower platelet count and clinical outcomes in patients with BCLC stage B hepatocellular carcinoma

  • Koji Fujita1
  • Mai Nakahara1
  • Hironobu Suto2
  • Asahiro Morishita1
  • Takashi Himoto3
  • Keiichi Okano2
  • Hideki Kobara1
  1. 1Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University
  2. 2Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University
  3. 3Department of Medical Technology, Kagawa Prefectural University of Health Sciences
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Abstract

Thrombocytosis is correlated with poor prognosis in several cancers. Barcelona Clinic liver cancer (BCLC) staging, a major index of prognosis prediction and treatment selection for patients with hepatocellular carcinoma (HCC), has not considered platelet count in its protocol yet. This study evaluated the prognostic impact of platelet count in patients with HCC. Briefly, this retrospective cohort study enrolled 925 patients with BCLC stage B HCC. Baseline characteristics were adjusted using propensity score matching. Log-rank tests were performed to determine whether a threshold platelet count of 150 × 109/L stratified patient prognosis. The primary endpoint was overall death. As a result, patients with platelet counts < 150 × 109/L showed significantly better overall survival compared to patients with platelet counts ≥ 150 × 109/L (hazard ratio = 0.7233). Among 553 patients with ≥ 4 HCC nodules, a platelet count cutoff of 150 × 109/L also differentiated patient prognosis (hazard ratio = 0.6059). After adjusting for the baseline characteristics of patients with ≥ 4 HCC by propensity score matching for age, sex, albumin, total bilirubin, primary or recurrence, and maximum tumor diameter, in the matched-pair cohorts, a platelet count < 150 × 109/L significantly correlated with a better overall survival compared to platelet count ≥ 150 × 109/L (hazard ratio = 0.7096). In conclusions, a lower platelet count correlated with better prognosis in patients with multiple HCC nodules.

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Cite

BibTeXRIS
BibTeX
@article{fujita2026lower,
  title = {{Lower platelet count and clinical outcomes in patients with BCLC stage B hepatocellular carcinoma}},
  author = {Koji Fujita and Mai Nakahara and Hironobu Suto and Asahiro Morishita and Takashi Himoto and Keiichi Okano and Hideki Kobara},
  journal = {Scientific Reports},
  year = {2026},
  month = aug,
  doi = {10.1038/s41598-026-65515-3},
  url = {https://doi.org/10.1038/s41598-026-65515-3},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Lower platelet count and clinical outcomes in patients with BCLC stage B hepatocellular carcinoma
AU  - Koji Fujita
AU  - Mai Nakahara
AU  - Hironobu Suto
AU  - Asahiro Morishita
AU  - Takashi Himoto
AU  - Keiichi Okano
AU  - Hideki Kobara
PY  - 2026
DA  - 2026/08/01
JO  - Scientific Reports
DO  - 10.1038/s41598-026-65515-3
UR  - https://doi.org/10.1038/s41598-026-65515-3
AB  - Thrombocytosis is correlated with poor prognosis in several cancers. Barcelona Clinic liver cancer (BCLC) staging, a major index of prognosis prediction and treatment selection for patients with hepatocellular carcinoma (HCC), has not considered platelet count in its protocol yet. This study evaluated the prognostic impact of platelet count in patients with HCC. Briefly, this retrospective cohort study enrolled 925 patients with BCLC stage B HCC. Baseline characteristics were adjusted using propensity score matching. Log-rank tests were performed to determine whether a threshold platelet count of 150 × 109/L stratified patient prognosis. The primary endpoint was overall death. As a result, patients with platelet counts < 150 × 109/L showed significantly better overall survival compared to patients with platelet counts ≥ 150 × 109/L (hazard ratio = 0.7233). Among 553 patients with ≥ 4 HCC nodules, a platelet count cutoff of 150 × 109/L also differentiated patient prognosis (hazard ratio = 0.6059). After adjusting for the baseline characteristics of patients with ≥ 4 HCC by propensity score matching for age, sex, albumin, total bilirubin, primary or recurrence, and maximum tumor diameter, in the matched-pair cohorts, a platelet count < 150 × 109/L significantly correlated with a better overall survival compared to platelet count ≥ 150 × 109/L (hazard ratio = 0.7096). In conclusions, a lower platelet count correlated with better prognosis in patients with multiple HCC nodules.
SN  - 2045-2322
ER  -