Abstract
BackgroundCoagulation and nutrition play important roles in cancer progression. The aim of the present study is to evaluate the prognostic value of the preoperative fibrinogen/albumin ratio (FAR) in surgical patients with soft tissue sarcoma (STS) and to compare this value with other inflammatory biomarkers. In addition, we investigated the relationship between FAR and the clinicopathological characteristics of STS patients.MethodsWe included 310 STS patients in this retrospective study. Kaplan-Meier curves, univariate and multivariate Cox proportional models were used in the prognostic analyses.ResultsAccording to the receiver operating characteristic (ROC) analysis, the optimal FAR cut-off value was 0.0726. The FAR exhibited a greater area under the curve (AUC) value (0.680) than did the NLR and PLR. An elevated FAR (≥0.0726) was significantly associated with an old age, large tumor size, deep tumor location, high tumor grade, and advanced American Joint Committee on Cancer (AJCC) stage.Patients with an increased FAR had a shorter median survival time and a lower 5-year overall survival (OS) rate than did those with a low FAR (61.0 vs115.8 months, P < 0.001; 56.7% vs 82.4%, P < 0.001, respectively). Multivariate analysis indicated FAR (Hazard ratio (HR) 1.907, 95% confidence interval (CI) 1.161–3.132, P < 0.001) to be an independent prognostic factor for OS, as were tumor depth, grade and PLR.ConclusionsPreoperative FAR is associated with tumor progression and can be considered an independent factor for OS of resected STS patients.
Highlights
Coagulation and nutrition play important roles in cancer progression
Accumulating data have demonstrated that preoperative malnutrition is associated with significantly short survival in soft tissue sarcoma (STS) patients [13], with serum albumin serving as a crucial parameter for nutritional status
The stage of each patient was classified according to the American Joint Committee on Cancer (AJCC) 7th Edition [14] and tumors were graded according to the French Federation of Cancer Centers Sarcoma Group (FNCLCC) grading system [15]
Summary
The aim of the present study is to evaluate the prognostic value of the preoperative fibrinogen/albumin ratio (FAR) in surgical patients with soft tissue sarcoma (STS) and to compare this value with other inflammatory biomarkers. Despite the improvement in surgical procedures and the development of adjuvant therapy [3], the long-term survival of STS patients with high-grade tumors is still poor. Many articles revealed that elevated preoperative plasma fibrinogen levels are significantly correlative with treatment failure or poor outcome in various malignancies [8,9,10], including STS [11, 12]. Accumulating data have demonstrated that preoperative malnutrition is associated with significantly short survival in STS patients [13], with serum albumin serving as a crucial parameter for nutritional status
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