Pretherapeutic Plasma Fibrinogen Level is an Independent Survival Predictor in Renal Cell Carcinoma

Abstract

Background: Systematic inflammatory responses such as the elevated C-reactive protein, erythrocyte sedimentation rate and lymphocyte-monocyte ratio have been found to have significant prognostic value in renal cell carcinoma (RCC). The purpose of this study was to identify the impact of pretherapeutic plasma fibrinogen levels on survival for RCC patients. Patients and Methods: We retrospectively reviewed 126 RCC patients who were treated at our institution. The median follow-up period was 30.8 months. 116 patients underwent nephrectomy. Results: The 3-year overall survival rates in patients with non-metastatic or metastatic RCC were 91.9% and 14.3%, respectively (p < 0.001). Pretherapeutic plasma fibrinogen levels in the metastatic group were significantly higher than those in the non-metastatic group (p < 0.001). In the non-metastatic group, multivariate analysis revealed that the pathological T stage (p = 0.008), lactate dehydrogenase (p = 0.007) and fibrinogen (p = 0.036) were independent prognostic factors for survival. Overall survival rates in patients with low fibrinogen levels (< 399 mg/dl) were significantly higher than in those with high fibrinogen levels (≥ 399 mg/dl). Conclusion: Pretherapeutic high plasma fibrinogen levels are associated with disease progression in patients with RCC of all stages. We propose that pretherapeutic plasma fibrinogen levels may become a useful biomarker, and could be helpful for decision making in the management of RCC.