Skip to main content

Advertisement

SpringerLink
Log in

Cumulative Prognostic Scores Based on Plasma Fibrinogen and Serum Albumin Levels in Esophageal Cancer Patients Treated with Transthoracic Esophagectomy: Comparison with the Glasgow Prognostic Score

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to establish a prognostic indicator based on preoperative plasma fibrinogen and serum albumin levels (FA score) in esophageal cancer patients and to compare the correlation with survival to that of the Glasgow prognostic score.

Methods

Patient characteristics, clinicopathological factors, and preoperative biochemical markers (fibrinogen, albumin, and C-reactive protein) were investigated in esophageal cancer patients who underwent transthoracic esophagectomy. Pretreatment fibrinogen and albumin levels were reviewed in patients who received neoadjuvant treatment. Patients with elevated fibrinogen and decreased albumin levels were allocated a score of 2, those with only one of these abnormalities were allocated a score of 1, and those with neither of these abnormalities were allocated a score of 0. The fibrinogen cut-off value was defined as 350 mg/dL according to our previous report, and the albumin cut-off value was defined as the lower quartile.

Results

Among 199 consecutive patients, the interquartile range of preoperative albumin was 3.8–4.3 g/dL and the cut-off value was 3.8 g/dL. Thus, 108 (54 %), 68 (34 %), and 23 (12 %) patients had an FA score of 0, 1, and 2. The patients with a high preoperative FA score showed considerably shorter disease-free survival (DFS) and overall survival (OS). Multivariate analysis showed that pretreatment stage and preoperative FA score were independently associated with postoperative DFS and OS.

Conclusions

Preoperative FA score was significantly associated with postoperative survival in esophageal cancer patients, and the prognostic value is currently being validated in a prospective multicenter cohort study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ando N, Kato H, Igaki H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19:68–74.

    Article  PubMed  Google Scholar 

  2. Forrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ. Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. Br J Cancer. 2004;90:1704–6.

    CAS  PubMed Central  PubMed  Google Scholar 

  3. Ahn HS, Lee HJ, Yoo MW, et al. Diagnostic accuracy of T and N stages with endoscopy, stomach protocol CT, and endoscopic ultrasonography in early gastric cancer. J Surg Oncol. 2009;99:20–7.

    Article  PubMed  Google Scholar 

  4. Lee HH, Lim CH, Park JM, et al. Low accuracy of endoscopic ultrasonography for detailed T staging in gastric cancer. World J Surg Oncol. 2012;10:190.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Ando M, Ando Y, Hasegawa Y, et al. Prognostic value of performance status assessed by patients themselves, nurses, and oncologists in advanced non-small cell lung cancer. Br J Surg. 2001;85:1634–9.

    CAS  Google Scholar 

  6. van Hagen P, Hulshof MC, van Lanschot JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366:2074–84.

    Article  PubMed  Google Scholar 

  7. Rajan R, Poniecka A, Smith TL, et al. Change in tumor cellularity of breast carcinoma after neoadjuvant chemotherapy as a variable in the pathologic assessment of response. Cancer. 2004;100:1365–73.

    Article  PubMed  Google Scholar 

  8. Forrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ. Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Br J Cancer. 2003;89:1028–30.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Takeuchi H, Ikeuchi S, Kitagawa Y, et al. Pretreatment plasma fibrinogen level correlates with tumor progression and metastasis in patients with squamous cell carcinoma of the esophagus. J Gastroenterol Hepatol. 2007;22:2222–7.

    Article  CAS  PubMed  Google Scholar 

  10. Matsuda S, Takeuchi H, Fukuda K, et al. Clinical significance of plasma fibrinogen level as a predictive marker for postoperative recurrence of esophageal squamous cell carcinoma in patients receiving neoadjuvant treatment. Dis Esophagus. 2013. doi::10.1111/dote.12115.

  11. Yamaguchi T, Yamamoto Y, Yokota S, Nakagawa M, Ito M, Ogura T. Involvement of interleukin-6 in the elevation of plasma fibrinogen levels in lung cancer patients. Jpn J Clin Oncol. 1998;28:740–44.

    Article  CAS  PubMed  Google Scholar 

  12. Tennent GA, Brennan SO, Stangou AJ, O’Grady J, Hawkins PN, Pepys MB. Human plasma fibrinogen is synthesized in the liver. Blood. 2007;109:1971–4.

    Article  CAS  PubMed  Google Scholar 

  13. Miki C, Konishi N, Ojima E, Hatada T, Inoue Y, Kusunoki M. C-reactive protein as a prognostic variable that reflects uncontrolled up-regulation of the IL-1–IL-6 network system in colorectal carcinoma. Dig Dis Sci. 2004;49:970–6.

    Article  CAS  PubMed  Google Scholar 

  14. Bloomston M, Zhou JX, Rosemurgy AS, Frankel W, Muro-Cacho CA, Yeatman TJ. Fibrinogen gamma overexpression in pancreatic cancer identified by large-scale proteomic analysis of serum samples. Cancer Res. 2006;66:2592–9.

    Article  CAS  PubMed  Google Scholar 

  15. Yamashita H, Kitayama J, Kanno N, Yatomi Y, Nagawa H. Hyperfibrinogenemia is associated with lymphatic as well as hematogenous metastasis and worse clinical outcome in T2 gastric cancer. BMC Cancer. 2006;6:147.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Zhao J, Zhao M, Jin B, et al. Tumor response and survival in patients with advanced non-small-cell lung cancer: the predictive value of chemotherapy-induced changes in fibrinogen. BMC Cancer. 2012;12:330.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Son HJ, Park JW, Chang HJ, et al. Preoperative plasma hyperfibrinogenemia is predictive of poor prognosis in patients with nonmetastatic colon cancer. Ann Surg Oncol. 2013;20:2908–13.

    Article  PubMed  Google Scholar 

  18. Palumbo JS, Kombrinck KW, Drew AF, et al. Fibrinogen is an important determinant of the metastatic potential of circulating tumor cells. Blood. 2000;96:3302–9.

    CAS  PubMed  Google Scholar 

  19. Palumbo JS, Potter JM, Kaplan LS, Talmage K, Jackson DG, Degen JL. Spontaneous hematogenous and lymphatic metastasis, but not primary tumor growth or angiogenesis, is diminished in fibrinogen-deficient mice. Cancer Res. 2002;62:6966–72.

    CAS  PubMed  Google Scholar 

  20. Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J. 2010;9:69.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Mackie IJ, Kitchen S, Machin SJ, Lowe GD. Guidelines on fibrinogen assays. Br J Haematol. 2003;121:396–404.

    Article  PubMed  Google Scholar 

  22. Kato H, Fukuchi M, Miyazaki T, et al. Classification of recurrent esophageal cancer after radical esophagectomy with two- or three-field lymphadenectomy. Anticancer Res. 2005;25:3461–7.

    PubMed  Google Scholar 

  23. Al Murri AM, Bartlett JM, Canney PA, Doughty JC, Wilson C, McMillan DC. Evaluation of an inflammation-based prognostic score (GPS) in patients with metastatic breast cancer. Br J Cancer. 2006;94:227–30.

    Article  CAS  PubMed  Google Scholar 

  24. Crumley AB, McMillan DC, McKernan M, McDonald AC, Stuart RC. Evaluation of an inflammation-based prognostic score in patients with inoperable gastro-oesophageal cancer. Br J Cancer. 2006;94:637–41.

    CAS  PubMed Central  PubMed  Google Scholar 

  25. Ishizuka M, Nagata H, Takagi K, Horie T, Kubota K. Inflammation-based prognostic score is a novel predictor of postoperative outcome in patients with colorectal cancer. Ann Surg. 2007;246:1047–51.

    Article  PubMed  Google Scholar 

  26. Crumley AB, Stuart RC, McKernan M, McDonald AC, McMillan DC. Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG-ps) in patients receiving palliative chemotherapy for gastroesophageal cancer. J Gastroenterol Hepatol. 2008;23:325–9.

    Article  Google Scholar 

  27. Ishizuka M, Nagata H, Takagi K, Kubota K. Influence of inflammation-based prognostic score on mortality of patients undergoing chemotherapy for far advanced or recurrent unresectable colorectal cancer. Ann Surg. 2009;250:268–72.

    Article  PubMed  Google Scholar 

  28. Roxburgh CS, Salmond JM, Horgan PG, Oien KA, McMillan DC. Comparison of the prognostic value of inflammation-based pathologic and biochemical criteria in patients undergoing potentially curative resection for colorectal cancer. Ann Surg. 2009;249:788–93.

    Article  PubMed  Google Scholar 

  29. Proctor MJ, Talwar D, Balmar SM, et al. The relationship between the presence and site of cancer, an inflammation-based prognostic score and biochemical parameters. Initial results of the Glasgow Inflammation Outcome Study. Br J Cancer. 2010;103:870–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  30. Nozoe T, Iguchi T, Egashira A, Adachi E, Matsukuma A, Ezaki T. Significance of modified Glasgow prognostic score as a useful indicator for prognosis of patients with gastric carcinoma. Am J Surg. 2011;201:186–91.

    Article  PubMed  Google Scholar 

  31. Leung EY, Scott HR, McMillan DC. Clinical utility of the pretreatment Glasgow prognostic score in patients with advanced inoperable non-small cell lung cancer. J Thoracic Oncol. 2012;7:655–62.

    Article  Google Scholar 

  32. Simpson-Haidaris PJ, Rybarczyk B. Tumors and fibrinogen. The role of fibrinogen as an extracellular matrix protein. Ann NY Acad Sci. 2001;936:406–25.

    Article  CAS  PubMed  Google Scholar 

  33. Palumbo JS, Talmage KE, Massari JV, et al. Platelets and fibrin(ogen) increase metastatic potential by impeding natural killer cell-mediated elimination of tumor cells. Blood. 2005;105:78–185.

    Article  CAS  PubMed  Google Scholar 

  34. Camerer E, Qazi AA, Duong DN, Cornelissen I, Advincula R, Coughlin SR. Platelets, protease-activated receptors, and fibrinogen in hematogenous metastasis. Blood. 2004;104:397–401.

    Article  CAS  PubMed  Google Scholar 

  35. Weisel JW. Fibrinogen and fibrin. Adv Protein Chem. 2005;70:247–99.

    Article  CAS  PubMed  Google Scholar 

  36. Zheng S, Shen J, Jiao Y, et al. Platelets and fibrinogen facilitate each other in protecting tumor cells from natural killer cytotoxicity. Cancer Sci. 2009;100:859–65.

    Article  CAS  PubMed  Google Scholar 

  37. Seth R, Tai LH, Falls T, et al. Surgical stress promotes the development of cancer metastases by a coagulation-dependent mechanism involving natural killer cells in a murine model. Ann Surg. 2013;258:158–68.

    Article  PubMed  Google Scholar 

Download references

Disclosure

Satoru Matsuda, Hiroya Takeuchi, Hirofumi Kawakubo, Kazumasa Fukuda, Rieko Nakamura, Tsunehiro Takahashi, Norihito Wada, Yoshiro Saikawa, Tai Omori, and Yuko Kitagawa have no conflicts of interest that are directly relevant to the content of this manuscript.

Author information

Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, Tokyo, Japan

    Satoru Matsuda MD, Hiroya Takeuchi MD, PhD, Hirofumi Kawakubo MD, PhD, Kazumasa Fukuda PhD, Rieko Nakamura MD, PhD, Tsunehiro Takahashi MD, PhD, Norihito Wada MD, PhD, Yoshiro Saikawa MD, PhD, Tai Omori MD & Yuko Kitagawa MD, PhD

Authors
  1. Satoru Matsuda MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroya Takeuchi MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hirofumi Kawakubo MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kazumasa Fukuda PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rieko Nakamura MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tsunehiro Takahashi MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Norihito Wada MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yoshiro Saikawa MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tai Omori MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yuko Kitagawa MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hiroya Takeuchi MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Matsuda, S., Takeuchi, H., Kawakubo, H. et al. Cumulative Prognostic Scores Based on Plasma Fibrinogen and Serum Albumin Levels in Esophageal Cancer Patients Treated with Transthoracic Esophagectomy: Comparison with the Glasgow Prognostic Score. Ann Surg Oncol 22, 302–310 (2015). https://doi.org/10.1245/s10434-014-3857-5

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-014-3857-5

Keywords

Search

Navigation