Prognostic value of preoperative plasma fibrinogen level and platelet-to-lymphocyte ratio (F-PLR) in patients with localized upper tract urothelial carcinoma.

Jiwei Huang,Wen Kong,Yanqing Wang,Yichu Yuan,Haige Chen,Jin Zhang,Yiran Huang,Yonghui Chen

doi:10.18632/oncotarget.13611

Jiwei Huang, Wen Kong + Show 6 more

Open Access

https://doi.org/10.18632/oncotarget.13611

Copy DOI

Journal: Oncotarget	Publication Date: Nov 25, 2016
Citations: 21	License type: cc-by

Affiliation: Shanghai Jiao Tong University

Abstract

PurposeHemostatic factors is thought to have a potentially significant role in progression and metastasis of malignant tumors. We investigated the prognostic value of preoperative plasma fibrinogen level and platelet-to-lymphocyte ratio (PLR) in localized upper tract urothelial carcinoma (UTUC).Materials and MethodsA total of 481 patients who underwent radical nephroureterectomy for localized UTUC (pTa-4N0M0) were identified between January 2002 and June 2013. Patients were assigned a F-PLR score of 0, 1, or 2 based upon the presence of elevated plasma fibrinogen level, an elevated PLR, or both. The association between F-PLR score and clinicopathological variables was analysed.ResultsThe optimal cut-off value of plasma fibrinogen and PLR for overall survival stratification was determined to be 4.22 and 241.2. Kaplan–Meier analysis revealed significant differences in cancer specific survival (CSS) and overall survival (OS) among patients with F–PLR scores of 0, 1 and 2. Multivariate analysis identified higher F–PLR score as an independent risk factor for CSS (P < 0.001) and OS (P < 0.001). The estimated c-index of the multivariate model for CSS and OS increased from 0.772 and 0.756 to 0.799 and 0.784 when F–PLR score added, which was higher than fibrinogen level, PLR or neutrophil-to-lymphocyte ratio added.ConclusionsPreoperative F-PLR score is a negative independent prognostic factor for survival outcomes in patients with localized upper tract urothelial carcinoma. Preoperative F-PLR score may become a useful biomarker, particularly because of its low associated cost and easy accessibility.

Highlights

Upper tract urothelial carcinoma (UTUC) is a relatively rare but aggressive malignant disease that accounts for only 5% to 10% of all urothelial carcinomas [1]
We investigated the prognostic value of preoperative plasma fibrinogen level and platelet-to-lymphocyte ratio (PLR) in localized upper tract urothelial carcinoma (UTUC)
The estimated c-index of the multivariate model for cancer specific survivals (CSS) and overall survival (OS) increased from 0.772 and 0.756 to 0.799 and 0.784 when F–PLR score added, which was higher than fibrinogen level, PLR or neutrophil-to-lymphocyte ratio added

Summary

Introduction

Upper tract urothelial carcinoma (UTUC) is a relatively rare but aggressive malignant disease that accounts for only 5% to 10% of all urothelial carcinomas [1]. Even after standard surgery of radical nephroureterectomy (RNU) in patients with UTUC, the prognosis for localized UTUC patients still remains poor. It is crucial to identify new risk factors, which would allow for better predicting individual surgical outcomes in localized UTUC patients who might benefit from individual patient treatment choices, such as neoadjuvant chemotherapy. Cancer is associated with hypercoagulopathy and increased risk of thrombosis [6]. Recent studies have proved that elevated plasma fibrinogen levels and platelet-to-lymphocyte ratio (PLR) are associated with worse clinical outcome in various human cancers [10,11,12,13]; there is no consensus as to which is a more reliable marker predicting the prognosis of cancer patients

Methods

Results

Conclusion