Affiliations: Department of Medical Oncology, The Affiliated Hospital of Jiangnan University, Wuxi 4th People's Hospital, Wuxi 214062, Jiangsu, China
Correspondence:
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Corresponding author: Dong Hua, Department of Medical Oncology, The Affiliated Hospital of Jiangnan University, Wuxi 4th People's Hospital, Huihe Road 200, Wuxi 214062, Jiangsu, China. Tel.: +86 051088682208; E-mail:alice1989211@gmail.com
Abstract: BACKGROUNDS:
Cancer progression has been associated with host hemostasis system. Whether
preoperative plasma hemostasis factors can predict survival in colorectal
cancer is quite intriguing.
METHODS:
We conducted a prospective cohort study to validate the prognostic
significance of three hemostasis parameters - fibrinogen, fibrin degradation
products (FDPs) and D-dimer - in non-metastatic colorectal cancer patients
treated with curative resection.
RESULTS:
All three parameters were positively correlated with C reactive protein
(CRP) levels and Glasgow Prognostic scores (GPS). In univariate cox hazards
regression model, as continuous variables, both fibrinogen (HR: 1.07,
95%CI: 1.01-1.13) and FDPs (HR: 1.17, 95%CI: 1.05-1.31) were
prognostic, while D-dimer levels were not. Patients with hyperfibrinogenemia
had a 2.12-fold increased mortality risk compared with patients without
hyperfibrinogenemia. Patients with positive FDPs had a 3.68-fold increased
mortality risk compared with patients with negative FDPs. In multivariate
models, hyperfibrinogenemia was prognostic (HR: 3.39, 95%CI: 1.34-8.67) in
patients with normal GPS scores.
CONCLUSIONS:
Preoperative fibrinogen levels appeared as an independent mortality risk
factor in non-metastatic colorectal cancer patients with normal GPS scores.
Fibrinogen could be a reliable marker to identify high risk patients for
those without systematic inflammation responses.
