Background: We aimed to evaluate the association of preoperative plasma fibrinogen levels with the clinicopathological parameters, disease-free survival, and overall survival in patients with renal cell carcinoma.
Methods: We retrospectively studied 286 patients with renal cell carcinoma who underwent radical nephrectomy from 2000 to 2003 at one center. The plasma fibrinogen was routinely determined before operation in all patients. The correlation of preoperative plasma fibrinogen levels with clinicopathological findings was evaluated by t-test or analysis of variance (ANOVA) methods. As well, univariate and multivariate analyses were used to determine the association between the preoperative level of plasma fibrinogen and survival duration.
Results: An elevated level of plasma fibrinogen was positively related to the Fuhrman grade (P < 0.001), tumor size (P < 0.001), and T stage (P < 0.001), but it was negatively related to histologic type (P = 0.266). Univariate analysis showed that the Fuhrman grade, tumor size, T stage, hemoglobin, corrected calcium, lactate dehydrogenase, and plasma fibrinogen level were significantly correlated with disease-free survival (P < 0.001, P < 0.001, P < 0.001, P < 0.001, P = 0.001, P < 0.001, and P < 0.001, respectively) and overall survival (P < 0.001, P = 0.001, P < 0.001, P < 0.001, P = 0.002, P = 0.001, and P < 0.001). Multivariate analysis showed that the plasma fibrinogen level remained as an independent prognostic factor for disease-free survival (P = 0.021) and overall survival (P < 0.001).
Conclusions: A high preoperative plasma fibrinogen level is an independent predictor of distant metastasis and survival prognosis after radical nephrectomy in patients with renal cell carcinoma.