title: High preoperative plasma fibrinogen is an independent predictor of distant metastasis and poor prognosis in renal cell carcinoma.
abstract: BACKGROUND
  We aimed to evaluate the association of preoperative plasma fibrinogen levels with the clinicopathological parameters, disease-free survival, and overall survival in patients with renal cell carcinoma.
  
  
  METHODS
  We retrospectively studied 286 patients with renal cell carcinoma who underwent radical nephrectomy from 2000 to 2003 at one center. The plasma fibrinogen was routinely determined before operation in all patients. The correlation of preoperative plasma fibrinogen levels with clinicopathological findings was evaluated by t-test or analysis of variance (ANOVA) methods. As well, univariate and multivariate analyses were used to determine the association between the preoperative level of plasma fibrinogen and survival duration.
  
  
  RESULTS
  An elevated level of plasma fibrinogen was positively related to the Fuhrman grade (P < 0.001), tumor size (P < 0.001), and T stage (P < 0.001), but it was negatively related to histologic type (P = 0.266). Univariate analysis showed that the Fuhrman grade, tumor size, T stage, hemoglobin, corrected calcium, lactate dehydrogenase, and plasma fibrinogen level were significantly correlated with disease-free survival (P < 0.001, P < 0.001, P < 0.001, P < 0.001, P = 0.001, P < 0.001, and P < 0.001, respectively) and overall survival (P < 0.001, P = 0.001, P < 0.001, P < 0.001, P = 0.002, P = 0.001, and P < 0.001). Multivariate analysis showed that the plasma fibrinogen level remained as an independent prognostic factor for disease-free survival (P = 0.021) and overall survival (P < 0.001).
  
  
  CONCLUSIONS
  A high preoperative plasma fibrinogen level is an independent predictor of distant metastasis and survival prognosis after radical nephrectomy in patients with renal cell carcinoma.
authors.affiliation: Department of Genitourinary Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Road, Hexi District, Tianjin, 300060, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Du
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Zheng
authors.forename: Xu-Sheng
authors.initials: XS
authors.lastname: Chen
authors.forename: Qing
authors.initials: Q
authors.lastname: Yang
authors.forename: Yan-Hui
authors.initials: YH
authors.lastname: Zhang
authors.forename: Lei
authors.initials: L
authors.lastname: Zhou
authors.forename: Xin
authors.initials: X
authors.lastname: Yao
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000097:blood / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D007680:Kidney Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology; D010949:Plasma / Q000378:metabolism*; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D005340:Fibrinogen