This study aimed to determine the prognostic value of preoperative plasma
fibrinogen concentration (PFC) in patients with stage I-II
gastric cancer after curative
gastrectomy. The preoperative PFC and clinicopathological data of 793 patients with stage I-II
gastric cancer who underwent curative
gastrectomy were analyzed retrospectively. PFC of <4.0 g/L and ≥4.0 g/L were considered as PFC0 and PFC1, respectively. The association between PFC and the clinicopathological features of
gastric cancer and the value of PFC in survival prediction were investigated. PFC1 indicated poorer overall survival and
cancer-specific survival among patients with
tumor-node-
metastasis (TNM) stage I-II, and PFC was identified as an independent
indicator of survival via multivariate analysis. Importantly, PFC stage was proven to be an independent prognostic factor for stage I and T1-4aN0
gastric cancer. PFC stage combined with the American Joint Committee on
Cancer (AJCC)-TNM stage has better accuracy for predicting disease prognosis than AJCC-TNM stage alone. The prognosis of patients with stage I-II
gastric cancer can be further stratified by PFC level. For patients with stage I
gastric cancer, PFC1 can be considered a high-risk prognostic factor, and
adjuvant chemotherapy should be recommended for patients with PFC1.