title: Preoperative plasma fibrinogen predicts cervical metastasis in patients with stage I/II carcinoma of the tongue.
abstract: The aim of this study was to evaluate the association of preoperative plasma fibrinogen levels with clinico-pathological parameters and disease-free survival in patients with oral tongue squamous cell carcinoma (OTSCC). We retrospectively studied 76 patients with OTSCC who underwent a partial glossectomy only, at a single centre, between 1996 and 2007. Among the 76 patients, 30 eventually developed cervical metastasis. Preoperative plasma fibrinogen levels were determined and correlated with clinico-pathological findings by t-test or analysis of variance methods. Univariate and multivariate analyses were used to determine the association of preoperative plasma fibrinogen levels and disease-free survival. Elevated levels of plasma fibrinogen were positively related with growth type (P<0.001), differentiation (P<0.001), thickness (P<0.001), and the infiltrative growth ratio (P=0.032). Univariate analysis showed that growth type (P<0.001), differentiation (P<0.001), thickness (P<0.001), and preoperative plasma fibrinogen levels (P<0.001) were significantly correlated with disease-free survival. Multivariate analysis showed that the plasma fibrinogen level remained an independent factor for disease-free survival after partial glossectomy for OTSCC (P=0.029). A high preoperative plasma fibrinogen level is an independent predictor of cervical metastasis after partial glossectomy for OTSCC. A conservative supraomohyoid neck dissection is appropriate in patients with stage I/II carcinoma of the tongue whose preoperative plasma fibrinogen is >300 mg/dl.
authors.affiliation: School of Stomatology, China Medical University, Shenyang, People's Republic of China; Department of Oral and Maxillofacial Surgery, Tianjin Stomatological Hospital, Tianjin, People's Republic of China.
authors.forename: P
authors.initials: P
authors.lastname: Peng
authors.affiliation: Department of Oral and Maxillofacial Surgery, Tianjin Stomatological Hospital, Tianjin, People's Republic of China.
authors.forename: J
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Head and Neck Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin, People's Republic of China.
authors.forename: J-B
authors.initials: JB
authors.lastname: Dong
authors.affiliation: School of Stomatology, China Medical University, Shenyang, People's Republic of China. Electronic address: dujun_1980@hotmail.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000556:secondary* / Q000601:surgery; D003952:Diagnostic Imaging; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005927:Glossectomy; D006258:Head and Neck Neoplasms / Q000556:secondary* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D014062:Tongue Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery
chemical_list: D005340:Fibrinogen
keywords: carcinoma; carcinoma of the tongue; conservative supraomohyoid neck dissection; fibrinogen; multivariate analysis