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We investigated the relationship between preoperative platelets count and the outcome of pancreatic cancer patients.We retrospectively reviewed the clinical records of 105 patients with invasive ductal carcinoma of the pancreas who underwent radical resection at our institution over a 20-year period. The patients were divided into two groups based on their preoperative platelets counts: a group with thrombocytosis (or = 40x10(4)/mL) and a group with non-elevated platelets counts (40x10(4)/mL). Histopathological findings, survival rates, recurrence patterns, and disease-free survival intervals were compared between the two groups.The outcome of the group with thrombocytosis was significantly poorer than that of the group with non-elevated platelets counts (p=0.043). The mean disease-free interval of patients with thrombocytosis was 4.9 months as opposed to 46.5 months for those with non-elevated platelets counts (p=0.006). Patients were classified into four groups according to changes in platelets counts after surgery. Consistently, the outcome of the group with both pre- and postoperative non-elevated platelets counts was the best compared to groups with post- and/or postoperative thrombocytosis.Our clinical data suggest that high platelets counts in the preoperative and postoperative period may be associated with a poor outcome and shortening of postoperative disease-free survival interval.