Preoperative serum fibrinogen is an independent prognostic factor in operable esophageal cancer.

// Shui-Shen Zhang 1, 2, 3, 4, * , Yi-Yan Lei 1, * , Xiao-Li Cai 5, * , Hong Yang 2, 3, 4 , Xin Xia 1 , Kong-Jia Luo 2, 3, 4 , Chun-Hua Su 1 , Jian-Yong Zou 1 , Bo Zeng 1 , Yi Hu 2, 3, 4 , Hong-He Luo 1 1 Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China 2 Guangdong Esophageal Cancer Research Institute, Guangzhou, People’s Republic of China 3 Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China 4 State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China 5 Department of Medical Ultrasonics, First Affiliated Hospital of Jinan University, Guangzhou, People’s Republic of China * These authors contributed equally to this work and share first authorship Correspondence to: Hong-He Luo, e-mail: luohhzm@163.com Yi Hu, e-mail: huyi@sysucc.org.cn Keywords: Chinese cohort, esophageal cancer, serum fibrinogen, overall survival, disease free survival Received: October 26, 2015     Accepted: March 02, 2016     Published: March 18, 2016 ABSTRACT In order to fully elucidate the association between serum fibrinogen and prognosis of esophageal cancer, we examined serum fibrinogen concentrations in 1512 patients who underwent esophagectomy by the Clauss method. The impact of fibrinogen on overall survival and disease-free survival was analyzed using the Kaplan-Meier method and Cox proportional hazard models. Hyperfibrinogenemia was significantly associated with older age, male gender, smoking, alcohol consumption, weight loss, advanced pathological T stage and lymph node metastasis. Patients with hyperfibrinogenemia exhibited poor OS (HR=1.20, 95%CI: 1.04-1.38, P =0.012) and DFS (HR=1.18, 95%CI: 1.03-1.35, P =0.019). Subgroup analysis further exhibited an significant association between hyperfibrinogenemia and poor OS ( P <0.001), DFS ( P <0.001) in esophageal squamous cell carcinoma ( P <0.001) and early pathological stage (I-II) ( P =0.001). Collectively, this study indicates that preoperative serum fibrinogen is an independent prognostic factor for survival in esophageal cancer.