Is Preoperative Fibrinogen Associated with the Survival Prognosis of Gastric Cancer Patients? A Multi-centered, Propensity Score-Matched Retrospective Study.

Abstract

BACKGROUND:

The prognostic significance of preoperative plasma fibrinogen in patients with operable gastric cancer remains under debate. This study aimed to elucidate the prognostic value of fibrinogen in gastric cancer patients underwent gastrectomy.

METHODS:

A total of 4351 patients with gastric cancer collected from three comprehensive medical centers were retrospectively evaluated. Patients were categorized by minimum P value using X-tile, while the baseline confounders for fibrinogen was balanced through propensity score matching (PSM). The relationships between fibrinogen and other clinicopathologic features were evaluated, and nomogram was constructed to assess its prognostic improvement compared with TNM staging system.

RESULTS:

Fibrinogen was significantly correlated with macroscopic type, tumor differentiation, tumor size, and T and N stage. The factors, fibrinogen and T stage as well as N stage, were identified to be independent prognostic factors after PSM. Nomogram based on fibrinogen demonstrated a smaller Akaike information criterion (AIC) and a larger concordance index (C-index) than TNM staging system, illustrating that fibrinogen might be able to improve the prognostic accuracy.

CONCLUSIONS:

Preoperative plasma fibrinogen levels in gastric cancer patients were significantly correlated with tumor progression, which could be regarded as a reliable marker for survival prognostic prediction.

• Authors: Lin-Yong Zhao, Yong-Liang Zhao, Jun-Jiang Wang, Qi-Di Zhao, Wen-Qi Yi, Qing Yuan, Xin-Zu Chen, Yong Li, Kun Yang, Xiao-Long Chen, Wei-Han Zhang, Kai Liu, Hua-Yang Pang, Danil Galiullin, Hui Wang, Li-Fei Sun, Xiao-Hai Song, Jia-Bin Zheng, Xue-Qing Yao, Zong-Guang Zhou, Pei-Wu Yu, Jian-Kun Hu
• Journal: World journal of surgery (World J Surg) Vol. 44 Issue 1 Pg. 213-222 (01 2020) ISSN: 1432-2323 [Electronic] United States
• PMID: 31637507 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Fibrinogen

Topics

• Adult
• Aged
• Female
• Fibrinogen (analysis)
• Gastrectomy
• Humans
• Male
• Middle Aged
• Neoplasm Staging
• Prognosis
• Propensity Score
• Retrospective Studies
• Stomach Neoplasms (blood, mortality, pathology, surgery)