Elevated plasma fibrinogen levels and prognosis of epithelial ovarian cancer: a cohort study and meta-analysis

Abstract

ObjectiveTo evaluate the effect of elevated plasma fibrinogen levels on the prognosis of epithelial ovarian cancer (EOC).MethodsWe reviewed the data of 217 patients with advanced-stage EOC between 2000 and 2012, and investigated the prognostic role of elevated plasma fibrinogen levels compared with serum CA-125 levels, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR). For further evaluation, we performed a meta-analysis using 5 cohort studies published to July 2015, including our cohort study after a literature review.ResultsAmong the four biomarkers, only plasma fibrinogen levels >485.2 mg/dL were correlated with impaired progression-free survival (PFS) and overall survival (OS) (median, 13.9 vs. 20.3 months and 42.2 vs. 55.4 months; p<0.010). Elevated plasma fibrinogen levels were an independent factor for poor PFS with marginal significance and OS (adjusted hazard ratios [HRs]=1.389 and 1.581; 95% confidence intervals [CIs]=0.979–1.972 and 1.032–2.423, respectively). Furthermore, crude and subgroup meta-analyses demonstrated that elevated plasma fibrinogen levels were associated with impaired PFS and OS in patients with all stage EOC.ConclusionElevated plasma fibrinogen levels be more important for predicting survival than serum CA-125 levels, NLR and PLR in patients with EOC, in particular, advanced-stage disease. Moreover, it may be related to poor prognosis of EOC.

Application of Artificial Intelligence for Preoperative Diagnostic and Prognostic Prediction in Epithelial Ovarian Cancer Based on Blood Biomarkers

“…A recent meta-analysis of data from 13 studies (n ¼ 3,467) showed that both high neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are associated with unfavorable prognosis of patients with EOC (25). In addition, elevated levels of pretreatment plasma D-dimer, Fbg, and PLT were found useful in predicting disease progression and survival outcomes of patients with EOC (26)(27)(28). These reports support our findings; indeed, additional studies using independent datasets are required to investigate how we can utilize this preoperative blood signature for accurate prognostic assessment of patients with EOC.…”

A cumulative score based on preoperative fibrinogen and the neutrophil&ndash;lymphocyte ratio to predict outcomes in resectable gastric cancer

“…In addition, much attention has been paid to the association between hypercoagulation and malignancy progression in recent years 29,30. Accumulating evidence indicates that the activation of the coagulation cascade plays a key pathophysiological role during tumor progression 31.…”

A Novel Prognostic Index in Patients with Resectable Esophageal Squamous Cell Carcinoma: Fibrinogen/Prealbumin Ratio

“…It has been reported that fibrinogen (Fib), a major protein in the blood clotting process, is associated with cancer 6 . Although recent studies have reported that plasma Fib was related to cancer progression and prognosis in various cancers [7][8][9] , the role of plasma Fib in EC remains controversial [10][11][12] .…”