Plasma Fibrinogen Levels and Prognosis in Patients with Ovarian Cancer: A Multicenter Study

Abstract

Abstract Learning Objectives After completing this course, the reader will be able to: Describe the role of fibrinogen in coagulation and the inflammatory response and explain its importance in tumor proliferation, migration, and escape from immune regulation.Evaluate fibrinogen as a prognostic blood marker for survival and disease-free survival in patients with ovarian cancer.Incorporate fibrinogen testing as a relatively inexpensive, reliable, and available technique in the prognostic evaluation of ovarian cancer patients. This article is available for continuing medical education credit at CME.TheOncologist.com Introduction. To evaluate pretherapeutic plasma fibrinogen levels as a prognostic parameter in patients with epithelial ovarian cancer (EOC). Materials and Methods. In the present multicenter study, pretherapeutic plasma fibrinogen levels were evaluated in 422 patients with EOC. Plasma fibrinogen levels were correlated with clinicopathological parameters and patient survival. Results. The mean (standard deviation) pretherapeutic plasma fibrinogen level was 450.0 (150.1) mg/dl. Elevated plasma fibrinogen levels were associated with advanced tumor stage (p = .01) and the presence of a postoperative residual tumor mass (p < .001), but not with histological grade (p = .1) and histological type (p = .8). In a multivariate Cox regression model, tumor stage (p < .001 and p < .001), postoperative residual tumor mass (p = .001 and p = .008), and plasma fibrinogen level (p < .001 and p = .002), but not histological type (p = .8 and p = .2), patient age (p = .9 and p = .9), and serum cancer antigen 125 (p = 0.2 and p = 0.3) and C-reactive protein (p = .2 and p = .3) levels, were associated with disease-free and overall survival, respectively. Histological grade was associated with overall but not with disease-free survival (p = .01 and p = .8), respectively. Conclusions. Pretherapeutic plasma fibrinogen levels can be used as an independent prognostic parameter in patients with EOC.