Prognostic significance of preoperative fibrinogen in patients with colon cancer

AIMTo evaluate the clinical significance of the preoperative fibrinogen plasma level as a prognostic marker after surgery for colorectal cancer.METHODSThis retrospective study analysed 652 patients undergoing surgery for stage I-IV colorectal cancer between January 2005 and December 2012, at the Division of General Surgery A, University of Verona Hospital Trust, in whom preoperative fibrinogen plasma values were assessed at baseline. Fibrinogen is involved in tumourigenesis as well as tumour progression in several malignancies. Correlations between preoperative plasma fibrinogen values and clinicopathological characteristics were investigated. Univariate and multivariate survival analyses were performed to identify factors associated with overall and tumour-related survival.RESULTSAmong the 652 patients, the fibrinogen value was higher than the threshold of 400 mg/dL in 345 patients (53%). The preoperative mean ± SD of fibrinogen was 426.2 ± 23.2 mg/dL (median: 409 mg/dL; range: 143-1045 mg/dL). Preoperative fibrinogen values correlated with age (P = 0.003), completeness of tumour resection, potentially curative vs palliative (P < 0.001), presence of systemic metastasis (P < 0.001), depth of tumour invasion pT (P < 0.001), nodes involvement pN (P = 0.001) and CEA serum level (P < 0.001). The mean fibrinogen value (± SD) was 395.6 ± 120.4 mg/dL in G1 tumours, 424.1 ± 121.4 mg/dL in G2 tumours and 453.4 ± 131.6 mg/dL in G3 tumours (P = 0.045). The overall survival and tumour-related survival were significantly higher in patients with fibrinogen values ≤ 400 mg/dL (P < 0.001). However, hyperfibrinogenemia did not retain statistical significance regarding either overall (P = 0.313) or tumour-related survival (P = 0.355) after controlling for other risk factors in a multivariate analysis.CONCLUSIONPreoperative fibrinogen levels correlate with cancer severity but do not help in predicting patient prognosis after colorectal cancer surgery.

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“…Similar results were reported by Sun et al[35] in 255 patients with CRC and Tang et al[23] in 341 patients submitted to curative CRC surgery.…”

Section: Discussionsupporting

confidence: 90%

Elevated fibrinogen plasma level is not an independent predictor of poor prognosis in a large cohort of Western patients undergoing surgery for colorectal cancer

Pedrazzani¹,

Mantovani²,

Salvagno³

et al. 2016

WJG

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“…Studies proved that elevated concentration of platelet count, D-dimer, and antithrombin III content had a strong association with a worse prognosis in NSCLC patients 29–31. Recent studies revealed that serum fibrinogen showed a correlation with prognosis in different cancers 32,33. Elevated fibrinogen level was found to be associated with poor prognosis acting as a predictive biomarker in NSCLC patients 11,12.…”

Section: Discussionmentioning

confidence: 98%

Plasma fibrinogen and serum albumin levels (FA score) act as a promising prognostic indicator in non-small cell lung cancer

Chen

Cheng

Nesa

et al. 2017

OTT

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BackgroundEvidence implies that preoperative plasma fibrinogen and serum albumin are associated with cancer prognosis. We aimed to explore the prognostic values of the score based on plasma fibrinogen and serum albumin levels (FA score) in non-small cell lung cancer (NSCLC), and to compare that with prognostic nutritional index (PNI).Patients and methodsIn all, 182 patients pathologically diagnosed with NSCLC were included in this study. Kaplan–Meier survival analysis and multivariate analysis were used in the prognostic analyses.ResultsHigh FA score was related to smoking (P=0.005), poor differential grade (P=0.002), and advanced T stage (P<0.001) and tumor, node, and metastases stage (P=0.011). Low PNI showed association with advanced T stage (P=0.030). Kaplan–Meier survival analysis indicated that high FA score and low PNI were associated with poor progression-free survival (PFS; for the FA score, P<0.001; for PNI, P=0.001) and overall survival (OS; for the FA score, P<0.001; for PNI, P=0.013), respectively. Multivariate analysis revealed that FA score was an independent predictor for PFS (P=0.003) and OS (P=0.001) in NSCLC patients.ConclusionThe FA score could act as a more promising prognostic predictor than PNI in NSCLC patients who underwent pneumonectomy.

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“…Fibrinogen is transformed to fibrin by activated thrombin in the coagulation cascade, which plays an important role in the malignant process of tumor progression and metastasis . Recent studies demonstrate that plasma fibrinogen levels are associated with tumor development in several types of malignancies . Similarly, NLR has been focused on as a prognostic factor in patients with many malignancies .…”

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confidence: 99%

Combined fibrinogen and neutrophil‐lymphocyte ratio as a prognostic marker of advanced esophageal squamous cell carcinoma

et al. 2017

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Patients with advanced esophageal squamous cell carcinoma (ESCC) is received chemoradiotherapy or chemotherapy for clinical management. However, it is difficult to predict tumor response and prognosis using blood markers before starting treatments. The purpose of this study was to investigate the pre‐treatment plasma fibrinogen and neutrophil–lymphocyte ratio (NLR) in patients with advanced ESCC treated with chemoradiotherapy or chemotherapy, and to assess the clinical utility of a combined score using these blood markers, named as the F‐NLR (fibrinogen and NLR) score, as a predictor of tumor response and prognosis. A total of 98 advanced ESCC patients, treated with chemoradiotherapy or chemotherapy, were classified into three groups: F‐NLR score of 2, having both hyperfibrinogenemia (>400 mg/dL) and high NLR (>3.0), score of 1, one of these hematological abnormalities, and score of 0, having neither hyperfibrinogenemia nor high NLR. Fibrinogen and NLR were significantly higher in the progressive disease (PD) group than the non‐PD group (P = 0.0419, and P = 0.0001, respectively). A significantly higher F‐NLR score was found in the PD group than the non‐PD group (P = 0.0140). Overall survival was significantly lower in patients with an F‐NLR score of 2 than in those with an F‐NLR score of 0 or 1 (P < 0.0001). Multivariate analysis showed that the F‐NLR score was one of the independent prognostic factors (P = 0.0081). Our study demonstrates that the F‐NLR score is promising as a predictive marker for therapeutic effects and prognosis in patients with advanced ESCC.

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Prognostic significance of preoperative fibrinogen in patients with colon cancer

Abstract: Preoperative fibrinogen levels can serve as an independent prognostic marker to evaluate patient response to colon cancer treatment.

Cited by 62 publications

References 29 publications

Elevated fibrinogen plasma level is not an independent predictor of poor prognosis in a large cohort of Western patients undergoing surgery for colorectal cancer

Elevated fibrinogen plasma level is not an independent predictor of poor prognosis in a large cohort of Western patients undergoing surgery for colorectal cancer

Plasma fibrinogen and serum albumin levels (FA score) act as a promising prognostic indicator in non-small cell lung cancer

Combined fibrinogen and neutrophil‐lymphocyte ratio as a prognostic marker of advanced esophageal squamous cell carcinoma

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