The pretreatment platelet and plasma fibrinogen level correlate with tumor progression and metastasis in patients with pancreatic cancer

Abstract

Cancer patients frequently present with activated coagulation pathways and thrombocytosis, which are potentially associated with tumor progression and prognosis. However, the prognostic value of abnormal plasma fibrinogen and platelet levels for the treatment of pancreatic cancer is unclear. The purpose of our study was to evaluate the prognostic value of plasma fibrinogen and platelet levels in pancreatic cancer, and to devise a prognostic model to identify the patients with greatest risk for a poor overall survival. One hundred and twenty-five patients diagnosed with pancreatic ductal adenocarcinoma in our hospital between May 2000 and June 2005 were included in this study. The plasma fibrinogen and platelet levels were examined before treatment and analyzed along with patient clinicopathological parameters and overall survival. The foundation of prognostic model was based on the risk factors according to the Cox proportional hazard model. The incidence of hyperfibrinogenemia and thrombocytosis was 24.8% (31/125) and 15.2% (19/125), respectively. The mean fibrinogen concentration differed significantly between the early (I/II) and late (III/IV) stage patients (3.19 ± 0.70 vs. 3.65 ± 0.90 g/l, p = 0.008). Patients with a higher concentration of plasma fibrinogen and platelets had a worse prognosis (p < 0.05). There also existed a significant correlation between higher fibrinogen/platelet levels and distant organ metastasis (p < 0.05, respectively). Bivariate correlation analysis showed that plasma fibrinogen levels correlated significantly with platelet levels (p = 0.000). Multivariate analysis revealed that pretreatment plasma fibrinogen levels (p = 0.027), tumor stage (p = 0.026) and distant metastasis (p = 0.027) were independent prognostic factors. The median survival time for the low-, intermediate-, and high-risk groups was 9.6 months (95% CI 6.2-13.0), 3.8 months (95% CI 2.3-5.3), and 2.3 months (95% CI 0.9-3.7), respectively (p = 0.000). Pretreatment plasma fibrinogen and platelet levels closely correlated with tumor progression, metastasis and overall survival in pancreatic cancer. The foundation of prognostic model may help us identify the greatest risk populations with pancreatic cancer.

Elevated platelet count is a strong predictor of poor prognosis in stage I non-small cell lung cancer patients

“…We found that the incidence of thrombocytosis was 8.5% (20/234) in stage I NSCLC patients. This result was consistent with the previous studies in gastric cancer (11.4%) [22], rectal cancer (8%) [23] and pancreatic cancer (15.2%) [24]. Elevated platelet count was related with NSCLC differentiation and T stage.…”

Hyperfibrinogenemia predicts poor prognosis in patients with advanced biliary tract cancer

“…In the present study, baseline hyperfibrinogenemia tended to be associated with late clinical stage, older age, and high PS. These findings are in accordance with previously published data for other malignancies [16][17][18], reflecting the suspicion that fibrinogen is involved in the progression and metastasis of BTC during the late phase of disease.…”

“…However, a convenient and dynamic means of monitoring clinical response or predicting prognosis has yet to be established. Recently, links between hyperfibrinogenemia and malignancies such as breast, gastric, lung, colorectal, pancreatic, and endometrial cancers have been increasingly recognized [14][15][16][17][24][25][26]. A previous retrospective study demonstrated that the preoperative plasma fibrinogen level was an independent marker of poor prognosis in gallbladder cancer patients following surgical resection [19]; however, no data have been reported on the clinicopathological and prognostic value of baseline plasma fibrinogen concentrations in patients with BTC.…”

“…Recent studies have indicated that preoperative hyperfibrinogenemia is associated with tumor progression and poor prognosis in several types of malignancies, including colorectal, gastric, pancreatic, and lung cancer [14][15][16][17]. Indeed, a previous study demonstrated that plasma fibrinogen is a predictive biomarker for evaluating chemotherapy response in patients with advanced non-smallcell lung carcinoma [18].…”

Pretreatment Plasma D-Dimer, Fibrinogen, and Platelet Levels Significantly Impact Prognosis in Patients With Epithelial Ovarian Cancer Independently of Venous Thromboembolism

“…A complete blood count was regularly taken, and thrombocytosis was defined as platelet count greater than 300 Â 10 9 /L. 36 …”