title: Cumulative prognostic scores based on plasma fibrinogen and serum albumin levels in esophageal cancer patients treated with transthoracic esophagectomy: comparison with the Glasgow prognostic score.
abstract: OBJECTIVE
  The purpose of this study was to establish a prognostic indicator based on preoperative plasma fibrinogen and serum albumin levels (FA score) in esophageal cancer patients and to compare the correlation with survival to that of the Glasgow prognostic score.
  
  
  METHODS
  Patient characteristics, clinicopathological factors, and preoperative biochemical markers (fibrinogen, albumin, and C-reactive protein) were investigated in esophageal cancer patients who underwent transthoracic esophagectomy. Pretreatment fibrinogen and albumin levels were reviewed in patients who received neoadjuvant treatment. Patients with elevated fibrinogen and decreased albumin levels were allocated a score of 2, those with only one of these abnormalities were allocated a score of 1, and those with neither of these abnormalities were allocated a score of 0. The fibrinogen cut-off value was defined as 350 mg/dL according to our previous report, and the albumin cut-off value was defined as the lower quartile.
  
  
  RESULTS
  Among 199 consecutive patients, the interquartile range of preoperative albumin was 3.8-4.3 g/dL and the cut-off value was 3.8 g/dL. Thus, 108 (54 %), 68 (34 %), and 23 (12 %) patients had an FA score of 0, 1, and 2. The patients with a high preoperative FA score showed considerably shorter disease-free survival (DFS) and overall survival (OS). Multivariate analysis showed that pretreatment stage and preoperative FA score were independently associated with postoperative DFS and OS.
  
  
  CONCLUSIONS
  Preoperative FA score was significantly associated with postoperative survival in esophageal cancer patients, and the prognostic value is currently being validated in a prospective multicenter cohort study.
authors: Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
authors: Satoru
authors: S
authors: Matsuda
authors: Hiroya
authors: H
authors: Takeuchi
authors: Hirofumi
authors: H
authors: Kawakubo
authors: Kazumasa
authors: K
authors: Fukuda
authors: Rieko
authors: R
authors: Nakamura
authors: Tsunehiro
authors: T
authors: Takahashi
authors: Norihito
authors: N
authors: Wada
authors: Yoshiro
authors: Y
authors: Saikawa
authors: Tai
authors: T
authors: Omori
authors: Yuko
authors: Y
authors: Kitagawa
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D004938:Esophageal Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D016629:Esophagectomy / Q000401:mortality*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis*; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D012709:Serum Albumin; D005340:Fibrinogen; D002097:C-Reactive Protein