Abstract
In order to fully elucidate the association between serum fibrinogen and prognosis of esophageal cancer, we examined serum fibrinogen concentrations in 1512 patients who underwent esophagectomy by the Clauss method. The impact of fibrinogen on overall survival and disease-free survival was analyzed using the Kaplan-Meier method and Cox proportional hazard models. Hyperfibrinogenemia was significantly associated with older age, male gender, smoking, alcohol consumption, weight loss, advanced pathological T stage and lymph node metastasis. Patients with hyperfibrinogenemia exhibited poor OS (HR=1.20, 95%CI: 1.04-1.38, P=0.012) and DFS (HR=1.18, 95%CI: 1.03-1.35, P=0.019). Subgroup analysis further exhibited an significant association between hyperfibrinogenemia and poor OS (P<0.001), DFS (P<0.001) in esophageal squamous cell carcinoma (P<0.001) and early pathological stage (I-II) (P=0.001). Collectively, this study indicates that preoperative serum fibrinogen is an independent prognostic factor for survival in esophageal cancer.
Highlights
Esophageal cancer is one of the most common cancers in the world, with over 480,000 new cases and 400,000 deaths annually, approximately half of whichoccur in China [1]
We examined serum fibrinogen concentrations according to patient characteristics and found similar results (Table 1)
Serum hyperfibrinogenemia has been demonstrated to be associated with tumor progression and unfavorable prognosis in multiple types of cancer, such as lung [6], colorectal [7], cervical [8], ovarian [9] and pancreatic cancer [10]
Summary
Esophageal cancer is one of the most common cancers in the world, with over 480,000 new cases and 400,000 deaths annually, approximately half of whichoccur in China [1]. In cancer, accumulating evidence has demonstrated that serum hyperfibrinogenemia is associated with malignant cell growth, progression and metastasis, such as lung [6], colorectal [7], cervical [8], ovarian [9] and pancreatic cancer [10]. Some recent studies indicate that hyperfibrinogenemia is more prevalent in esophageal cancer patients and it contributes to tumor progression, metastasis, poor survival and resistance to chemoradiotherapy [11,12,13]. The significance of serum fibrinogen concentration in operable esophageal cancer patients as a predictor of survival remains understudied. In order to fill this gap, we analyzed a large cohort of Chinese patients to elucidate www.impactjournals.com/oncotarget the potential correlation between serum fibrinogen and prognostic survival
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