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Usefulness of Preoperative Plasma Fibrinogen Versus Other Prognostic Markers for Predicting Gastric Cancer Recurrence

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Abstract

Background

Hypercoagulation is associated with tumor progression and metastasis in various types of malignancy. We compared the prognostic value of preoperative plasma fibrinogen level with those of other prognostic markers in patients with gastric cancer and assessed whether fibrinogen level was an independent prognostic indicator.

Methods

We collected preoperative data from 609 consecutive patients with gastric cancer who underwent curative gastrectomy. A receiver operating curve (ROC) was used to compare the sensitivity and specificity of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), C-reactive protein (CRP), platelet count, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and fibrinogen level in predicting recurrence. Recurrence-free survival (RFS) and overall survival (OS) were compared between the normal and high fibrinogen groups.

Results

In the ROC analysis, the area under the curve (AUC) was 0.534 for CEA, 0.552 for CA19-9, 0.587 for CRP, 0.565 for platelet count, 0.567 for PLR, 0.522 for NLR, and 0.692 for fibrinogen. Plasma fibrinogen level increased with tumor stage. The high fibrinogen (≥350 mg/dl) group had significantly worse RFS (p < 0.001) and OS (p < 0.001) than the normal fibrinogen (<350 mg/dl) group. Cox multivariate analysis of RFS revealed that fibrinogen level was an independent prognostic factor (p < 0.001) in addition to sex, pT stage, and pN stage.

Conclusions

Preoperative plasma fibrinogen level had the highest predictive value for recurrence among seven known prognostic markers. Since fibrinogen level is an independent factor for RFS, it would be useful for predicting prognosis after gastric cancer surgery.

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Acknowledgments

The authors had no financial support for the research reported.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0871, Japan

    Masaaki Yamamoto, Yukinori Kurokawa, Yasuhiro Miyazaki, Tomoki Makino, Tsuyoshi Takahashi, Makoto Yamasaki, Kiyokazu Nakajima, Shuji Takiguchi, Masaki Mori & Yuichiro Doki

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  1. Masaaki Yamamoto
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  2. Yukinori Kurokawa
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  3. Yasuhiro Miyazaki
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  4. Tomoki Makino
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  5. Tsuyoshi Takahashi
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  6. Makoto Yamasaki
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  7. Kiyokazu Nakajima
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  8. Shuji Takiguchi
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  9. Masaki Mori
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  10. Yuichiro Doki
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Correspondence to Yukinori Kurokawa.

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Yamamoto, M., Kurokawa, Y., Miyazaki, Y. et al. Usefulness of Preoperative Plasma Fibrinogen Versus Other Prognostic Markers for Predicting Gastric Cancer Recurrence. World J Surg 40, 1904–1909 (2016). https://doi.org/10.1007/s00268-016-3474-5

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  • DOI: https://doi.org/10.1007/s00268-016-3474-5

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