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01-08-2017 | Original Scientific Report

Preoperative Plasma Fibrinogen is Associated with Lymph Node Metastasis and Predicts Prognosis in Resectable Esophageal Cancer

Authors: Kohei Wakatsuki, Sohei Matsumoto, Kazuhiro Migita, Masahiro Ito, Tomohiro Kunishige, Hiroshi Nakade, Mitsuhiro Nakatani, Mutsuko Kitano, Masayuki Sho

Published in: World Journal of Surgery | Issue 8/2017

Abstract

Background

Although it is well known that patients with malignant tumors have abnormal blood coagulation, its clinical significance has not been studied. We investigated the clinicopathological and prognostic impact of plasma fibrinogen, which is the major factor of the coagulation system, in patients with esophageal cancer.

Methods

From February 1995 to December 2006, 100 patients with esophageal cancer who had their plasma fibrinogen measured were enrolled. The associations between plasma fibrinogen, clinicopathological factors, and prognosis were analyzed. A concentration of 2.0–4.0 g/L was defined as normofibrinogenemia, and a concentration higher than 4.0 g/L was described as hyperfibrinogenemia.

Results

Patients with large, advanced tumors, and lymph node metastasis had significantly higher plasma fibrinogen than those with small, early tumors, and no lymph node metastasis (p < 0.001, p = 0.002, and p = 0.03, respectively). Plasma fibrinogen was associated with not only the existence of lymph node metastasis but also the extension of lymph node metastasis and lymphatic recurrence. Patients with hyperfibrinogenemia had a significantly poor prognosis as compared to those with normofibrinogenemia, regardless of pathological staging. Plasma fibrinogen was an independent risk factor for overall survival and relapse-free survival as well as tumor depth and lymph node metastasis (p = 0.004 and p = 0.031, respectively).

Conclusion

Preoperative plasma fibrinogen is a possible biomarker for the prediction of tumor progression, recurrence pattern, and prognosis for esophageal cancer. Preoperative plasma fibrinogen is also associated with lymph node metastasis and may be helpful in adjusting neo-adjuvant therapy.

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Title: Preoperative Plasma Fibrinogen is Associated with Lymph Node Metastasis and Predicts Prognosis in Resectable Esophageal Cancer
Authors: Kohei Wakatsuki
Sohei Matsumoto
Kazuhiro Migita
Masahiro Ito
Tomohiro Kunishige
Hiroshi Nakade
Mitsuhiro Nakatani
Mutsuko Kitano
Masayuki Sho
Publication date: 01-08-2017
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 8/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-3991-x

At a glance: The STEP trials

Springer Medicine

Preoperative Plasma Fibrinogen is Associated with Lymph Node Metastasis and Predicts Prognosis in Resectable Esophageal Cancer

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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