The role of fibrinogen as a predictor in preoperative chemoradiation for rectal cancer.
BACKGROUND
To perform chemoradiotherapy (CRT) effectively, it is clinically beneficial to identify predictors of tumor response after CRT. This study examined the association between plasma fibrinogen level before preoperative CRT and tumor response in advanced rectal cancer.


METHODS
This was a retrospective study of 947 patients who received preoperative CRT followed by curative surgery for primary rectal cancer. We analyzed clinical factors that could be associated with pathologic tumor response in terms of downstaging (ypStage 0-I), primary tumor regression (ypT0-1), and complete response (ypT0N0).


RESULTS
Downstaging was observed in 366 patients (38.6%), primary tumor regression in 187 patients (19.7%) and complete response in 138 patients (14.6%). Multivariate analysis found that pre-CRT carcinoembryonic antigen (CEA) level, fibrinogen level, hemoglobin level, clinical T and N classification, distance from anal verge, and histologic grade were significant predictive factors for downstaging; CEA level, fibrinogen level, and N classification predicted primary tumor regression; CEA level, and fibrinogen level were predictive for complete response.


CONCLUSIONS
This study demonstrated that fibrinogen level was a significant predictor of pathologic tumor response after preoperative CRT.
Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
Jong Hoon
JH
Lee
Jong Hee
JH
Hyun
Dae Yong
DY
Kim
Byong Chul
BC
Yoo
Ji Won
JW
Park
Sun Young
SY
Kim
Hee Jin
HJ
Chang
Byung Chang
BC
Kim
Tae Hyun
TH
Kim
Jae Hwan
JH
Oh
Dae Kyung
DK
Sohn
D000230:Adenocarcinoma / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood; D059248:Chemoradiotherapy; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012372:ROC Curve; D012004:Rectal Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D012074:Remission Induction; D012189:Retrospective Studies
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D005340:Fibrinogen