Fibrinogen Is A Coagulation Marker Associated With The Prognosis Of Endometrial Cancer

Qing Li; Rong Cong; Fanfei Kong; Jian Ma; Qijun Wu; Xiaoxin Ma

doi:10.2147/OTT.S222813

Fibrinogen Is A Coagulation Marker Associated With The Prognosis Of Endometrial Cancer

Onco Targets Ther. 2019 Nov 19:12:9947-9956. doi: 10.2147/OTT.S222813. eCollection 2019.

Authors

Qing Li¹, Rong Cong¹, Fanfei Kong¹, Jian Ma¹, Qijun Wu², Xiaoxin Ma¹

Affiliations

¹ Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
² Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.

Abstract

Purpose: The present study aimed to identify coagulation markers with prognostic value in the setting of surgically treated endometrial cancer.

Patients and methods: A total of 942 patients with endometrial cancer who underwent surgery were included in the study. The preoperative prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), prothrombin time activity (PTA), fibrinogen and D-dimer values were analyzed to determine their potential associations with clinicopathological characteristics. Survival analysis was performed using the Kaplan-Meier method, p-values were calculated using the log-rank text, and the prognostic factors were evaluated using Cox's proportional hazards regression model.

Results: The preoperative plasma fibrinogen and D-dimer concentrations were significantly different among patients with different ages, pre/post-menopausal status, International Federation of Obstetrics and Gynecology Association (FIGO) stage, tumor grade, depth of myometrial invasion, histological type and lymphatic vessel space invasion. Fibrinogen level was also asscoiated with body mass index (BMI) and comorbidities, and D-dimer level was asscoiated with preoperative radiotherapy and chemotherapy. APTT was different in patients in pre/post-menopausal status and with or without comorbidities. PTA was asscoiated with BMI and lymphovascular invasion. TT was different between different age groups, different menopause status groups, as well as different FIGO stage groups. A multivariate analysis identified high fibrinogen levels (>3.25 g/L) as an independent prognostic factor for overall survival (HR=1.807; 95% CI=1.003-3.253; p=0.049).

Conclusion: High pretreatment fibrinogen levels are associated with poor overall survival and represent a valuable independent prognostic factor in patients with endometrial cancer. PT, aPTT, TT, PTA and D-dimer levels cannot be used as independent prognostic factors for endometrial cancer.

Keywords: clinicopathological characteristics; endometrial carcinoma; hemostatic markers; survival.