Plasma Fibrinogen Acts as a Predictive Factor for Pathologic Complete Response to Neoadjuvant Chemotherapy in Breast Cancer: A Retrospective Study of 1035 Chinese Breast Cancer Patients

Abstract

Background: The aim of this study was to evaluate the relationship between pre-treatment plasma fibrinogen (Fib) level and pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer patients and to assess the role of plasma Fib as a predictive factor.Methods: Data from 1035 consecutive patients with invasive breast cancer who received NAC and subsequent surgery were retrospectively analysed. Both univariate and multivariate analyses were performed to identify clinicopathological factors associated with pCR to NAC.Results: The median value of Fib, rather than other plasma coagulation parameters, was significantly increased in non-pCR patients compared with pCR patients (P = 0.008). Based on the cut-off value estimated by the ROC curve analysis, samples were divided into low or high Fib groups (Fib < 3.145 g/L or ≥ 3.145 g/L). Low Fib status was significantly associated with premenopausal or perimenopausal status (P < 0.001), ≤ 5cm tumour size (P = 0.001), positive hormone receptor status (P = 0.003) and > 14% Ki67 index (P = 0.028). Adjusted for other clinicopathologic factors in the multivariate logistic regression model, low Fib status was strongly associated with pCR to NAC (OR = 2.365, 95% CI = 1.354-4.133, P = 0.002).Conclusions: This study demonstrates that low pre-treatment plasma Fib (Fib < 3.145 g/L) is an independent predictive factor for pCR to NAC in breast cancer patients.