The high levels of fibrinogen and platelets are associated with poor survival in nephroblastoma in children

Background: Pediatric nephroblastoma is the most common abdominal malignancy in children. Hyperfibrinogenemia and thrombocytosis are often associated with malignancy and poor prognosis. This study aimed to investigate the relationship between high fibrinogen and platelet levels and the clinicopathologic features as well as overall survival in pediatric nephroblastoma.

Methods: We recruited a total of 129 nephroblastoma patients in this research. The patients were evaluated retrospectively using the Kaplan-Meier method and Log rank test to investigate the correlation between patient survival and fibrinogen and platelet levels. A multivariate Cox regression model and a predictive nomogram have also been constructed.

Results: Our findings indicated that fibrinogen levels were associated with Children's Oncology Group (COG) stage (P<0.001), pathological typing (P<0.001), hematuresis (P=0.002), hypertension (P=0.02), and venous thrombosis (P<0.001). Platelet levels were associated with COG stage (P<0.001), pathological typing (P<0.001), hematuresis (P=0.001), and venous thrombosis (P<0.001). Elevated fibrinogen and platelet levels are associated with poor overall survival (P<0.001). Multivariate analysis also indicated that elevated fibrinogen and platelet were independent risk factors (P=0.02, and P<0.001). The nomogram model demonstrates its application value in predicting the prognosis of pediatric nephroblastoma. The calibration curve validates that the predictions made by the nomogram model are in agreement with the actual observed survival outcomes.

Conclusions: High levels of platelets and fibrinogen may have negative effects on the prognosis of children with nephroblastoma.