You have accessJournal of UrologyKidney Cancer: Evaluation & Staging (II)1 Apr 2013731 A LARGE SCALE VALIDATION STUDY PROPOSES HIGH PRE-OPERATIVE PLASMA FIBRINOGEN LEVELS AS AN INDEPENDENT NEGATIVE PROGNOSTIC FACTOR REGARDING CANCER-SPECIFIC, METASTASIS-FREE, AS WELL AS OVERALL SURVIVAL IN A EUROPEAN COHORT OF RENAL CELL CARCINOMA PATIENTS Georg C. Hutterer, Martin Pichler, Caroline Stoeckigt, Thomas F. Chromecki, Tatjana Stojakovic, Silvia Golbeck, Sebastian Mannweiler, Karl Pummer, and Richard Zigeuner Georg C. HuttererGeorg C. Hutterer Graz, Austria More articles by this author , Martin PichlerMartin Pichler Graz, Austria More articles by this author , Caroline StoeckigtCaroline Stoeckigt Graz, Austria More articles by this author , Thomas F. ChromeckiThomas F. Chromecki Graz, Austria More articles by this author , Tatjana StojakovicTatjana Stojakovic Graz, Austria More articles by this author , Silvia GolbeckSilvia Golbeck Graz, Austria More articles by this author , Sebastian MannweilerSebastian Mannweiler Graz, Austria More articles by this author , Karl PummerKarl Pummer Graz, Austria More articles by this author , and Richard ZigeunerRichard Zigeuner Graz, Austria More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.294AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The plasma fibrinogen level has been proposed as a relevant factor in human tumor cell invasion as well as in the development of metastatic disease. Previous findings from small-scale studies have indicated plasma fibrinogen levels as a prognostic factor for the clinical outcome in non-metastatic renal cell carcinoma (RCC) patients. Thus, we decided to evaluate the prognostic significance of fibrinogen in a large cohort of RCC patients. METHODS Data from 994 consecutive non-metastatic RCC patients, operated with radical nephrectomy or nephron sparing surgery between 2000 and 2010 at a single tertiary academic center, were evaluated retrospectively. The pre-operative plasma fibrinogen levels were calculated one day before surgical intervention. Patients were categorized using an optimized cut-off value of 466mg/dL according to a receiver operating under the curve (ROC) analysis. Cancer-specific-, metastasis-free-, as well as overall survival were assessed using the Kaplan-Meier method. To evaluate the independent prognostic significance of plasma fibrinogen levels, a multivariate Cox regression model was performed for all three endpoints. RESULTS An increased plasma fibrinogen level was associated with several well established prognostic factors including age, advanced tumor stage, tumor grade and histologic tumor necrosis (all p<0.05). In multivariate analyses, increased plasma fibrinogen levels were statistically significantly associated with poor outcomes regarding cancer-specific- (HR=2.47, 95%CI=1.49-4.11, p<0.001), metastasis-free- (HR=2.15, 95%CI=1.44-3.22, p<0.001), as well as overall survival (HR=2.48, 95%CI=1.80-3.40, p<0.001). CONCLUSIONS Regarding patients' cancer-specific-, metastasis-free-, as well as overall survival in the cohort studied, the pre-operative plasma fibrinogen level represented a strong and independent prognostic factor. Thus, we believe that this easily identifiable laboratory parameter should be considered as an additional prognostic factor in future. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e300-e301 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Georg C. Hutterer Graz, Austria More articles by this author Martin Pichler Graz, Austria More articles by this author Caroline Stoeckigt Graz, Austria More articles by this author Thomas F. Chromecki Graz, Austria More articles by this author Tatjana Stojakovic Graz, Austria More articles by this author Silvia Golbeck Graz, Austria More articles by this author Sebastian Mannweiler Graz, Austria More articles by this author Karl Pummer Graz, Austria More articles by this author Richard Zigeuner Graz, Austria More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...