Reply to the Letter to the Editor Entitled “Too Many versus Too Few Platelets in Patients with Hepatocellular Carcinoma: Good or Bad?”

Dear Editor, We want to thank Huo and Liu [1] for their great interest in our paper [2] and for sharing their data. Indeed, thrombocytosis was repeatedly associated with a worse prognosis in patients with various cancer entities [3, 4]. Prophylactic treatment with acetylsalicylic acid does not only reduce the risk of cancer development [5] but may also reduce the risk of distant metastasis formation [6]. Following the findings of Huo and Liu [1], we performed a pooled analysis of our two cohorts comparing the overall survival (OS) of patients with thrombocytopenia (platelets < 150 g/L), normal platelet count (150–350 g/L), and thrombocytosis (≥350 g/L). As shown in Figure 1, OS was significantly reduced with Received: October 7, 2019 Accepted: October 9, 2019 Published online: December 11, 2019