Dataset Information

Prognostic role of preoperative platelet, fibrinogen, and D-dimer levels in patients with non-small cell lung cancer: A multicenter prospective study.

ABSTRACT:

Background

The relationships between coagulation factors and non-small cell lung cancer (NSCLC) prognosis have been intensively studied. However, no previous study has investigated the combined effects of preoperative platelet (PLT), fibrinogen (FIB), and D-dimer (D-D) levels on the prognosis of NSCLC.

Methods

A multicenter prospective study was conducted over seven hospitals. A total of 395 patients diagnosed with operable NSCLC for the first time were included and followed-up until disease progression or the end of the study. Baseline demographic and clinicopathological information, and preoperative coagulation test results were collected for each patient. Univariate and multilevel survival analyses were conducted using Cox regression and shared frailty models.

Results

Multilevel analyses revealed that there was a marginally significant association between elevated PLT level (> 215 × 10⁹ /L) and unfavorable progression-free survival (PFS) (hazard ratio 2.42, P = 0.05), whereas preoperative FIB and D-D were not significant prognostic factors for PFS (P = 0.31 and 0.30, respectively). Compared to patients with one elevation of the three coagulation factors, patients with at least two elevations of the three factors had a significantly higher risk of cancer progression (hazard ratio 4.62, P = 0.02).

Conclusion

The number of elevated preoperative coagulation factors may have a significant effect on PFS and could be used to predict the prognosis of NSCLC patients after surgery. Future studies are warranted to further investigate the interactions between these three coagulation factors.

SUBMITTER: Hou C

PROVIDER: S-EPMC6360242 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Publications

Prognostic role of preoperative platelet, fibrinogen, and D-dimer levels in patients with non-small cell lung cancer: A multicenter prospective study.

Hou Can C Jiang Feng F Ma Haitao H Zhu Quan Q Wang Zhonglin Z Zhao Biao B Xue Tao T Tan Sheng S Yang Rusong R Qian Yongxiang Y Luo Xuan X Zhao Ming M Xu Xing X Chen Liang L Li Jiayuan J

Thoracic cancer 20190104 2

<h4>Background</h4>The relationships between coagulation factors and non-small cell lung cancer (NSCLC) prognosis have been intensively studied. However, no previous study has investigated the combined effects of preoperative platelet (PLT), fibrinogen (FIB), and D-dimer (D-D) levels on the prognosis of NSCLC.<h4>Methods</h4>A multicenter prospective study was conducted over seven hospitals. A total of 395 patients diagnosed with operable NSCLC for the first time were included and followed-up un ...[more]

PMID: 30609303

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Project description:BackgroundPlasma D-dimer is of great significance for the clinical exclusion of tumor-related thrombosis. Previous studies have shown its predictive role in non-small cell lung cancer (NSCLC) treated with chemotherapy. However, whether pretreatment D-dimer could predict the efficacy and prognosis in NSCLC patients treated with immune checkpoint inhibitors (ICIs) remains unclear.MethodsAdvanced NSCLC patients treated with ICIs at the Chinese PLA General Hospital between January 2015 and March 2019 were enrolled. Patients were divided into a pretreatment normal D-dimer group (≤0.5 µg/mL) and high D-dimer group (>0.5 µg/mL). Optimization-based approach was applied to balance baseline covariates between the 2 groups, including age, sex, histological type, smoking history, stage, Eastern Cooperative Oncology Group Performance Status (ECOG PS), lines of treatment, ICI drugs, brain metastasis, treatment type, and D-dimer levels. Kaplan-Meier analysis and Cox proportional hazards model were used for analyzing survival data, including progression-free survival (PFS, the time from initial ICI treatment to PD or death), overall survival (OS, the time between initial ICI treatment and death), and hazard ratio (HR). Follow-up of all patients was performed by searching electronic medical records and counseling telephone. The follow-up cut-off date was July 6, 2020.ResultsThis study included 277 advanced NSCLC patients. Among the enrolled patients, 23.1% were female, 64.6% had non-squamous cell lung cancer, and 79.4% were stage IV. Univariate and multivariate analysis showed that pretreatment high D-dimer levels were independently associated with shortened PFS and OS (P<0.01). Subgroup analysis confirmed that pretreatment high D-dimer levels were associated with poor prognosis in most subsets. After balancing baseline covariates between the high D-dimer group and normal D-dimer group, the results indicated that patients with pretreatment high D-dimer levels had significantly shorter PFS [median: 6.4 vs. 11.5 months; HR, 1.70; 95% confidence ratio (CI): 1.25-2.37; P<0.001] and OS (median: 12.7 vs. 30.4 months; HR, 2.29; 95% CI: 1.54-3.41; P<0.001) than those with pretreatment normal D-dimer levels.ConclusionsPretreatment plasma D-dimer could serve as a convenient prognostic biomarker for advanced NSCLC patients receiving ICI treatment. Patients with pretreatment high D-dimer levels may have poor PFS and OS.

Project description:Background: Both nutritional status and coagulation function are closely associated with prognosis in patients with bladder cancer (BC). This study aimed to investigate the prognostic value of albumin-to-fibrinogen ratio (AFR) for BC patients underwent radical cystectomy (RC) or transurethral resection of bladder tumor (TURBT), and develop predictive nomograms based on AFR. Methods: We retrospectively collected medical records of 358 BC patients who underwent RC or TURBT between January 2012 and December 2018. The whole cohort was divided into the training (215 patients, 60.06%) and validation cohorts (143 patients, 39.94%) based on surgery dates. The training cohort was applied to select characteristics and construct nomograms, while the validation cohort was used to verify the nomograms independently. Endpoints of the current study included overall survival (OS), disease-specific survival (DSS) and disease-free survival (DFS). Prognostic values of AFR and other characteristics were evaluated using univariate and multivariate Cox regression analyses and compared using the concordance-index (C-index). Nomograms for OS, DSS and DFS were constructed based on both-directional stepwise Cox proportional hazards regression analysis and evaluated by the receiver operating characteristic (ROC) curve, the C-index and calibration plot. Results: In whole cohort, 86 patients (24.02%) were classified into low AFR group and had worse OS (hazard ratio [HR]: 4.079, 95% confidence interval [CI]: 2.085-7.982, P < 0.001), DSS (HR: 3.012, 95% CI: 1.302-6.966, P = 0.010) and DFS (HR: 1.863, 95% CI: 1.204-2.883, P = 0.005) compared to BC patients in high AFR group. Meanwhile, the AFR processed better prognostic power than albumin and fibrinogen, individually. Multivariate Cox analysis indicated that AFR was an independent prognostic factor for OS (HR: 2.601, 95% CI: 1.057-6.395, P = 0.037) and DFS (HR: 1.971, 95% CI: 1.049-3.703, P = 0.035). Novel nomograms, incorporating AFR, tumor grade and tumor multifocality, were constructed and successfully validated for predictions of OS, DSS and DFS in BC. Conclusions: Preoperative AFR was identified as an independent prognostic predictor for OS and DFS of BC patients underwent surgery. The nomograms incorporating AFR provided accurate predictions for OS, DSS and DFS, which could help urologists in better clinical decision-making.

Dataset Information

Prognostic role of preoperative platelet, fibrinogen, and D-dimer levels in patients with non-small cell lung cancer: A multicenter prospective study.

Background

Methods

Results

Conclusion

Publications

Prognostic role of preoperative platelet, fibrinogen, and D-dimer levels in patients with non-small cell lung cancer: A multicenter prospective study.

Similar Datasets

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