Open AccessIs Preoperative Fibrinogen Associated with the Survival Prognosis of Gastric Cancer Patients? A Multi‐centered, Propensity Score‐Matched Retrospective Study
Author(s) -
Zhao LinYong,
Zhao YongLiang,
Wang JunJiang,
Zhao QiDi,
Yi WenQi,
Yuan Qing,
Chen XinZu,
Li Yong,
Yang Kun,
Chen XiaoLong,
Zhang WeiHan,
Liu Kai,
Pang HuaYang,
Galiullin Danil,
Wang Hui,
Sun LiFei,
Song XiaoHai,
Zheng JiaBin,
Yao XueQing,
Zhou ZongGuang,
Yu PeiWu,
Hu JianKun
Publication year - 2020
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-019-05191-9
Subject(s) - medicine , fibrinogen , nomogram , cancer , stage (stratigraphy) , gastrectomy , propensity score matching , oncology , retrospective cohort study , tnm staging system , proportional hazards model , gastroenterology , neoplasm staging , paleontology , biology
Background The prognostic significance of preoperative plasma fibrinogen in patients with operable gastric cancer remains under debate. This study aimed to elucidate the prognostic value of fibrinogen in gastric cancer patients underwent gastrectomy. Methods A total of 4351 patients with gastric cancer collected from three comprehensive medical centers were retrospectively evaluated. Patients were categorized by minimum P value using X‐tile, while the baseline confounders for fibrinogen was balanced through propensity score matching (PSM). The relationships between fibrinogen and other clinicopathologic features were evaluated, and nomogram was constructed to assess its prognostic improvement compared with TNM staging system. Results Fibrinogen was significantly correlated with macroscopic type, tumor differentiation, tumor size, and T and N stage. The factors, fibrinogen and T stage as well as N stage, were identified to be independent prognostic factors after PSM. Nomogram based on fibrinogen demonstrated a smaller Akaike information criterion (AIC) and a larger concordance index (C‐index) than TNM staging system, illustrating that fibrinogen might be able to improve the prognostic accuracy. Conclusions Preoperative plasma fibrinogen levels in gastric cancer patients were significantly correlated with tumor progression, which could be regarded as a reliable marker for survival prognostic prediction.