Preoperative serum fibrinogen is an independent prognostic factor in operable esophageal cancer

Abstract

In order to fully elucidate the association between serum fibrinogen and prognosis of esophageal cancer, we examined serum fibrinogen concentrations in 1512 patients who underwent esophagectomy by the Clauss method. The impact of fibrinogen on overall survival and disease-free survival was analyzed using the Kaplan-Meier method and Cox proportional hazard models. Hyperfibrinogenemia was significantly associated with older age, male gender, smoking, alcohol consumption, weight loss, advanced pathological T stage and lymph node metastasis. Patients with hyperfibrinogenemia exhibited poor OS (HR=1.20, 95%CI: 1.04-1.38, P=0.012) and DFS (HR=1.18, 95%CI: 1.03-1.35, P=0.019). Subgroup analysis further exhibited an significant association between hyperfibrinogenemia and poor OS (P<0.001), DFS (P<0.001) in esophageal squamous cell carcinoma (P<0.001) and early pathological stage (I-II) (P=0.001). Collectively, this study indicates that preoperative serum fibrinogen is an independent prognostic factor for survival in esophageal cancer.

Hepatitis B Virus Infection is a Prognostic Biomarker for Better Survival in Operable Esophageal Cancer: Analysis of 2,004 Patients from an Endemic Area in China

“…We identified consecutive patients with esophageal cancer who underwent surgical resection at Sun Yat-sen University Cancer Center (Guangzhou, China) between December 2000 and December 2008 (17,18). All patients were newly confirmed to have esophageal cancer and had not received treatment.…”

“…Patients were excluded on the basis of the following criteria: history of other cancer; prior neoadjuvant therapy; died in the perioperative period; lack of information on HBV infection or hepatitis viral infections other than HBV. Esophagectomy and pathologic stage was described in our previous study (17,18). All patients provided written informed consent for their information to be stored and used in the hospital database.…”

“…Standardized follow-up was described in our previous study (18). Follow-up continued until June 2013.…”

“…The median follow-up time was 32.1 months. Overall survival (OS) and disease-free survival (DFS) are the endpoints as described previously in our study (18).…”

Coagulation and fibrinolysis in gastric cancer

“…[98][99][100] Hyperfibrinogenemia is increasingly recognized as an important risk factor influencing cancer development and outcome, associated with poor prognosis in various cancers (e.g., ovarian, biliary, esophageal, and pancreatic). 26,[101][102][103][104][105][106] Globally, an elevated content of FBG in plasma before treatment significantly correlates with decreased survival in patients with solid tumors. 107 Recently, in rectal cancer tissues, Repetto et al 108 identified FBG ␤ chain as a marker for identification of poor responders before therapy.…”