Plasma Fibrinogen Predicts the Prognosis of Bladder Cancer Patients After Radical Cystectomy

Shuai Yang; Han Guan; Sheng Wang; Hongliang Wu; Wenyan Sun; Zhijun Chen; Qingwen Li

doi:10.2147/CMAR.S269244

Plasma Fibrinogen Predicts the Prognosis of Bladder Cancer Patients After Radical Cystectomy

Cancer Manag Res. 2020 Sep 29:12:9303-9314. doi: 10.2147/CMAR.S269244. eCollection 2020.

Authors

Shuai Yang^#¹, Han Guan^#¹, Sheng Wang¹, Hongliang Wu¹, Wenyan Sun¹, Zhijun Chen¹, Qingwen Li¹

Affiliation

¹ Department of Urology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233000, People's Republic of China.

^# Contributed equally.

Abstract

Background: This study aimed to determine the potential utility of plasma fibrinogen as a prognostic factor in patients with bladder cancer (BCa) after radical cystectomy (RC).

Methods: Patients with BCa who underwent RC from 2014 to 2019 were analyzed retrospectively. The indexes of plasma coagulation and fibrinolysis system factors were collected. Kaplan-Meier survival curves were used to calculate the overall survival (OS) and disease-free survival (DFS). The prognostic value of plasma fibrinogen was analyzed by using Cox regression model, and a nomogram of BCa based on plasma fibrinogen was generated by R software.

Results: Among 145 patients, the optimal cut-off value of plasma fibrinogen was 3.14g/L. High level of plasma fibrinogen was related to the poor prognosis of patients with BCa, and plasma fibrinogen has a more accurate prognostic ability than other plasma coagulation and fibrinolysis system factors. Multivariate Cox regression analysis showed that plasma fibrinogen was an independent predictor of OS (>3.14 vs ≤3.14 HR, 2.58, 95% CI = 1.28-5.23; p = 0.008) and DFS (>3.14 vs ≤3.14 HR, 2.60, 95% CI = 1.20-5.65; p = 0.016), and the nomogram based on plasma fibrinogen had better accuracy and discrimination (area under the curve (AUC): OS = 0.741, DFS = 0.733).

Conclusion: Plasma fibrinogen can be used as an independent predictor of OS and DFS for RC patients, and the nomogram based on plasma fibrinogen was a reliable model for predicting the prognosis after RC.

Keywords: bladder cancer; nomogram; plasma fibrinogen; prognosis; radical cystectomy.

Grants and funding

This work was supported by the Key Projects of Natural Science Foundation of Colleges and Universities in Anhui Province [grant numbers KJ2019A0355], Science Foundation of Bengbu Medical College [grant numbers BYKY1840ZD] and Natural Science Foundation of Anhui Province [grant numbers 2008085QH358].