High Preoperative Fibrinogen Level is Closely Associated with Receipt of Chemotherapy and Advanced Disease in Patients with Colorectal Cancer

Abstract

Background: There is still lack of a preoperative simple, reliable and non-invasive blood marker predicting the stage of the disease (luminal or extraluminal) and the need for chemotherapy at the time of diagnosis in patients with colorectal cancer (CRC). The study aimed to investigate any relationship between the preoperative fibrinogen level and CRC disease stage as well as the receipt of chemotherapy before surgery. Method: A total 297 CRC patients undergoing surgical resection for any reason (curative or palliative) enrolled in this study. The serum fibrinogen level was calculated in the preoperative period. The need for chemotherapy was assessed by two different expert oncologists. Comparisons were made between the fibrinogen level with disease stage as well as the chemotherapy. Results: The mean fibrinogen level was 455±128,5 mg/dL with high level in 77,4% of all CRC patients. The level of fibrinogen in both Duke’s C and D significantly were higher than Duke’s B (p<0,001). High preoperative fibrinogen level had a 27.9-fold increase the risk of receiving chemotherapy (Hazard Ratio:27.9, P<0.0001, 12.8-60.4; 95% C.I). The majority of CRC patients receiving chemotherapy (94,4%) had both high fibrinogen and CEA levels. Conclusion: High preoperative fibrinogen is closely linked with receipt of chemotherapy and advanced disease in patients with CRC. Notable, this association is more prominent when fibrinogen and CEA are both high.