A retrospective discussion of the prognostic value of combining prothrombin time(PT) and fibrinogen(Fbg) in patients with Hepatocellular carcinoma

Abstract

Aims: The levels of coagulation system tests have been studied in various cancers. In this study, our aim is to evaluate the prognostic value of pretreatment plasma coagulation tests in hepatocellular carcinoma (HCC) patients. Patient and methods: A retrospective study was performed in 539 patients with HCC, and follow-up period was at least 60 months until recurrence or death. The prognostic significance of coagulation system tests (prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen) were determined by univariate and multivariate Cox hazard models. Then, according to the results of the multivariate analyses, we proposed the coagulation-Based Stage, which combined the independent risk factors (prothrombin time and fibrinogen). Results: Coagulation system tests including prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fbg) were analyzed. Patients with prolonged PT (≥12.1 sec) levels had significantly poor overall survival (OS) and disease-free survival (DFS), not only in the entire cohort (HR: 1.661, 95%CI: 1.125-2.451, p=0.011 vs. HR: 1.660, 95%CI: 1.125-2.451, p=0.011), but also in the subgroups stratified by pathological stage (stage I-II and stage III-IV). Additionally, high Fbg (≥2.83 g/L) levels experienced significantly decreased OS and DFS (HR: 2.158, 95%CI: 1.427-3.263, p<0.001 vs. HR: 2.161, 95%CI: 1.429-3.267, p<0.001), not only in the entire cohort but also in the subgroups stratified by pathological stage (stage I-II and stage III-IV). All the patients were then stratified (based on combined PT and Fbg) into three groups, The OS for HCC patients were (41.37±17.76), (31.83±19.84) and (18.68±18.41) months, and the DFS for HCC patients were (41.15±17.88), (31.65±19.81) and (18.66±18.39) months. Conclusions: Our findings suggest that the combination of plasma PT and Fbg levels should be evaluated as the valuable predictor of survival in patients with HCC.

Study of coagulation profile in hepatic disorders in a Tertiary Care Centre

“…This is in accordance with the findings of Xue-Ping Wang et al [9] . Platelet count was normal in all cases of liver SOL in present study as opposed to 46.01% observed in Xue-Ping Wang et al [9] . This difference may be due to the difference in total study population.…”

Preoperative Albumin-Bilirubin Score for Postoperative Solitary Hepatocellular Carcinoma within the Milan Criteria and Child-Pugh A Cirrhosis

“…Surgical resection remains the initial treatment of choice for most of early stage HCC patients because it is likely to yield a better prognosis than radiofrequency ablation (RFA) treatment 5 , 6 . Previous studies have elucidated the factors that influence the prognosis of postoperative HCC patients 7 - 11 .…”

“…The current prognostic models for HCC include parameters related to HCC, such as the tumour diameter, tumour number, presence of vascular invasion, and extent of tumour differentiation and lymph node metastasis 7 , 8 . Previous studies have reported that there is a significantly different prognosis between early HCC patients within the Milan criteria and cases beyond this criterion 9 , 10 .…”

Hemastatic biomarkers as prognostic factors in locoregionally advanced nasopharyngeal carcinoma treated with nimotuzumab plus chemoradiotherapy

“…Mounting evidence demonstrated that prolonged PT was associated with poor prognosis in lung cancer [16,17], pancreatic cancer [18], colorectal cancer [19], and hepatocellular carcinoma [20]. The exact mechanisms underlying this association remain unclear.…”