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There are limited data in patients with hepatocellular carcinoma (HCC), which often occurs in patients with cirrhosis and portal hypertension. We aimed to explore the prognostic value of thrombocytosis in two cohorts of patients with HCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We included 3561 patients from Taiwan and 1145 patients from the USA. Thrombocytopenia was defined as platelet count\u00a0&lt;\u00a0150\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L and thrombocytosis as\u00a0\u2265\u00a0300\u00a0\u00d7\u00a010\n                      <jats:sup>9<\/jats:sup>\n                      \/L at HCC diagnosis. We used multivariable Cox proportional hazard models to identify independent predictors of survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thrombocytosis was present in 9.0% and 6.9% of Taiwan and USA patients respectively. Compared to patients with normal platelet counts and those with thrombocytopenia, patients with thrombocytosis had larger tumours, increased vascular invasion and a higher proportion had extrahepatic metastases in both cohorts. In multivariable analysis, thrombocytosis (aHR 1.40, 95% CI 1.23\u20101.60) and thrombocytopenia (aHR 1.13, 95% CI 1.04\u20101.23) were both associated with worse survival after adjusting for age, gender, liver disease aetiology, Child\u2010Pugh score, maximal tumour size, tumour nodularity, vascular invasion, lymph node or distant metastasis, performance status and alpha\u2010fetoprotein level. Patients with thrombocytosis had a median survival of 6 and 4\u00a0months in the Taiwan and USA cohorts, compared to 32 and 14\u00a0months for those with normal platelet counts and 38 and 16\u00a0months for thrombocytopenic patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Thrombocytosis is independently associated with increased tumour burden and worse overall survival among HCC patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.14560","type":"journal-article","created":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T13:33:25Z","timestamp":1591623205000},"page":"2522-2534","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Thrombocytosis is associated with worse survival in patients with hepatocellular carcinoma"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6205-3704","authenticated-orcid":false,"given":"Po\u2010Hong","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Medicine Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Department of Medicine UT Southwestern Medical Center Dallas TX USA"},{"name":"Faculty of Medicine National Yang\u2010Ming University School of Medicine Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010Yang","family":"Hsu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine National Yang\u2010Ming University School of Medicine Taipei Taiwan"},{"name":"Division of Gastroenterology and Hepatology University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3889-7004","authenticated-orcid":false,"given":"Chien\u2010Wei","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Medicine Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Faculty of Medicine National Yang\u2010Ming University School of Medicine Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5241-5425","authenticated-orcid":false,"given":"Yi\u2010Hsiang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Medicine Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Faculty of Medicine National Yang\u2010Ming University School of Medicine Taipei Taiwan"},{"name":"Institute of Clinical Medicine National Yang\u2010Ming University School of Medicine Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Chih","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Medicine Taipei Veterans General Hospital Taipei Taiwan"},{"name":"Faculty of Medicine National Yang\u2010Ming University School of Medicine Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole E.","family":"Rich","sequence":"additional","affiliation":[{"name":"Department of Medicine UT Southwestern Medical Center Dallas TX USA"},{"name":"Division of Digestive and Liver Disease UT Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Department of Medicine UT Southwestern Medical Center Dallas TX USA"},{"name":"Division of Digestive and Liver Disease UT Southwestern Medical Center Dallas TX USA"},{"name":"Department of Gastroenterology Graduate School of Medicine University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujin","family":"Hoshida","sequence":"additional","affiliation":[{"name":"Department of Medicine UT Southwestern Medical Center Dallas TX USA"},{"name":"Division of Digestive and Liver Disease UT Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit G.","family":"Singal","sequence":"additional","affiliation":[{"name":"Department of Medicine UT Southwestern Medical Center Dallas TX USA"},{"name":"Division of Digestive and Liver Disease UT Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2202-521X","authenticated-orcid":false,"given":"Teh\u2010Ia","family":"Huo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine National Yang\u2010Ming University School of Medicine Taipei Taiwan"},{"name":"Institute of Pharmacology National Yang\u2010Ming University School of Medicine Taipei Taiwan"},{"name":"Departments of Medical Research Taipei Veterans General Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,28]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"FerlayJ ErvikM LamF et al.Global Cancer Observatory: 2018 Cancer Today. 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