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World Journal of Urology

, Volume 33, Issue 10, pp 1467–1473 | Cite as

The association of an elevated plasma fibrinogen level with cancer-specific and overall survival in prostate cancer patients

  • Eva-Maria Thurner
  • Sabine Krenn-Pilko
  • Uwe Langsenlehner
  • Tatjana Stojakovic
  • Martin Pichler
  • Armin Gerger
  • Karin S. Kapp
  • Tanja LangsenlehnerEmail author
Original Article

Abstract

Purpose

Fibrinogen plays an important role in the pathophysiology of tumour cell invasion and metastases. In recent studies, an elevated plasma fibrinogen level has been associated with poor prognosis in different types of cancer. The present study was performed to analyse the prognostic impact of an elevated fibrinogen level in prostate cancer patients.

Methods

We evaluated data from 268 prostate cancer patients who underwent 3D conformal radiotherapy between 1999 and 2006 at a single tertiary academic center. Cancer-specific survival (CSS), overall survival (OS), and clinical disease-free survival (DFS) were assessed using the Kaplan–Meier method. Univariable and multivariable Cox regression models were performed for each endpoint.

Results

Applying receiver operating characteristics (ROC) curve analysis, the optimal cut-off level for the plasma fibrinogen level was 530 mg dl−1, respectively. Univariable (HR 3.638, 95 % CI 1.15–11.47, p = 0.027) and multivariable analyses (HR 3.964, 95 % CI 1.06–14.87, p = 0.041) revealed a significant correlation between increased plasma fibrinogen and CSS. Univariable analysis also showed a significant association between the elevated plasma fibrinogen level and decreased OS (HR 3.242, 95 % CI 1.53–6.89, p = 0.002), that remained significant in multivariable analysis (HR 3.215, 95 % CI 1.44–7.19, p = 0.004). No significant associations were found for clinical DFS.

Conclusion

Although our data show a significant association between an elevated plasma fibrinogen level and poor prostate cancer prognosis, they have to be interpreted cautiously. Limitations of the present study are caused by its retrospective design, the limited accuracy obtained using ROC curve analysis, and potential confounding factors like cardiovascular disease and inflammatory diseases that have not been accounted for.

Keywords

Prostate cancer Radiotherapy Prognosis Coagulation Fibrinogen 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

The study complied with the Declaration of Helsinki and has been approved by the local Ethical Committee.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Eva-Maria Thurner
    • 1
  • Sabine Krenn-Pilko
    • 1
  • Uwe Langsenlehner
    • 2
  • Tatjana Stojakovic
    • 3
  • Martin Pichler
    • 4
  • Armin Gerger
    • 4
  • Karin S. Kapp
    • 1
  • Tanja Langsenlehner
    • 1
    Email author
  1. 1.Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center GrazMedical University of GrazGrazAustria
  2. 2.Division of Internal MedicineOutpatient Department GrazGrazAustria
  3. 3.Clinical Institute of Medical and Chemical Laboratory DiagnosticsMedical University of GrazGrazAustria
  4. 4.Division of Clinical Oncology, Department of MedicineMedical University of GrazGrazAustria

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