Prognostic value of plasma fibrinogen and D-dimer levels in patients with surgically resected non-small cell lung cancer

Surg Today. 2020 Nov;50(11):1427-1433. doi: 10.1007/s00595-020-02019-1. Epub 2020 May 14.

Abstract

Purpose: A high plasma level of either fibrinogen or D-dimer has been shown to correlate with a poor prognosis in patients with surgically resected non-small-cell lung cancer (NSCLC). The present study aimed to identify whether or not both markers combined had a superior prognostic value to either alone.

Methods: Of the 1344 patients who underwent surgical resection for NSCLC at our institution between January 2007 and December 2016, 1065 had preoperative plasma fibrinogen and D-dimer data available and were included in the analysis.

Results: The recurrence-free survival (RFS) and overall survival (OS) rates were similar for patients with high plasma levels of either or both fibrinogen (> 4.0 g/L) or D-dimer (> 1.0 μg/mL); therefore, these three groups were combined for a further analysis into a single group with high plasma levels of either or both proteins. The high-level group had significantly lower 5-year RFS (53% vs. 68%, p < 0.001) and 5-year OS (65% vs. 80%, p < 0.001) rates than patients with normal plasma levels of fibrinogen and D-dimer (control group).

Conclusions: Our results suggest that preoperative tests for both plasma fibrinogen and D-dimer are necessary to identify patients with surgically resected NSCLC likely to have a poor RFS and OS.

Keywords: Non-small cell lung cancer; Plasma D-dimer; Plasma fibrinogen; Prognostic factors.

MeSH terms

  • Aged
  • Biomarkers, Tumor / blood*
  • Blood Coagulation Disorders / diagnosis*
  • Blood Coagulation Disorders / etiology
  • Carcinoma, Non-Small-Cell Lung / complications
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Disease-Free Survival
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis*
  • Fibrinogen / analysis*
  • Fibrinolysis
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / mortality
  • Lung Neoplasms / surgery*
  • Male
  • Pneumonectomy*
  • Preoperative Period
  • Prognosis
  • Survival Rate
  • Thrombophilia / diagnosis*
  • Thrombophilia / etiology
  • Venous Thromboembolism / diagnosis*
  • Venous Thromboembolism / etiology

Substances

  • Biomarkers, Tumor
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D
  • Fibrinogen