Reply to Cengiz Beyan and Esin Beyan. Mean platelet volume may not be a significant prognostic factor in patients with m
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LETTER TO THE EDITOR
Reply to Cengiz Beyan and Esin Beyan. Mean platelet volume may not be a significant prognostic factor in patients with metastatic castration‑resistant prostate cancer. Int J Clin Oncol 97(2), 3–4, 2020 Wataru Fukuokaya1 · Takahiro Kimura1 · Fumihiko Urabe1 · Shoji Kimura1 · Kojiro Tashiro1 · Shunsuke Tsuzuki1 · Yusuke Koike1 · Hiroshi Sasaki1 · Kenta Miki1 · Shin Egawa1 Received: 30 September 2020 / Accepted: 13 October 2020 © Japan Society of Clinical Oncology 2020
We have read with great interest the letter to the editor by Esin regarding our manuscript on the value of pretreatment mean platelet volume (MPV) as a treatment-specific prognostic factor for patients with metastatic castration-resistant prostate cancer (mCRPC) [1, 2]. The authors pointed out that the conclusion on the value of MPV was extremely optimistic because of several methodological issues regarding the measurement of MPV. The MPV (the average size of platelets) is thought to be a useful parameter for measuring functional changes and activation of platelets [3]. Moreover, it could also reflect changes in rates of platelet production [3]. As the authors * Wataru Fukuokaya [email protected] Takahiro Kimura [email protected] Fumihiko Urabe [email protected] Shoji Kimura shoji.kimura‑[email protected] Kojiro Tashiro [email protected] Shunsuke Tsuzuki [email protected] Yusuke Koike y‑[email protected] Hiroshi Sasaki [email protected] Kenta Miki [email protected] Shin Egawa s‑[email protected] 1
Department of Urology, The Jikei University School of Medicine, 3‑25‑8 Nishi‑shimbashi, Minato‑ku, Tokyo 105‑8461, Japan
have extensively discussed [4–8], various factors, such as the measurement method, content of anticoagulant during blood count, and collection time (time from puncture of a vein to measurement), influence the value of MPV. First, the accuracy of the measurement of platelets collected in ethylenediaminetetraacetic acid (EDTA)-coated tube is decreased over time, and a previous study recommended to perform the measurement within 2 h after collection [9]. In our institution, complete blood count (CBC) analysis is routinely performed within 2 h after collection. Thus, the measurement delay did not seem to influence our study findings. Second, as mentioned above, our institution uses mostly EDTA-coated tubes for CBC analysis, except for patients with EDTA-dependent pseudothrombocytopenia. The difference in the measurement device could not affect the results. However, the measurement deviation should be evaluated in a further study to confirm our findings. We agree that the retrospective nature of our study might have been a limitation. In addition, the optimal cutoff value of MPV for predicting events in patients with mCRPC is still to be determined. However, as discussed in the article, the hazard plot showed that the risk of events (radiographic and prostate-specific antigen progression-free survival) increased as the MPV decreased, suggesting our results might be maintained at a different cut
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