title: Preoperative peripheral plasma fibrinogen level is an independent prognostic marker in penile cancer.
abstract: OBJECTIVE
  High levels of peripheral plasma fibrinogen have recently been revealed that related to poor clinical prognosis in various types of malignant tumors. The purpose of this research was to identify the prognostic significance of the preoperative peripheral serum fibrinogen level in patients with penile cell carcinoma.
  
  
  METHODS
  This retrospective research included 72 penile cancer patients with date about their serum fibrinogen value before surgery who undergone either partial or radical penectomy at The 2nd Hospital of Tianjin Medical University between January 2002 to January 2012. They had a mean follow-up of 30.8 months. To determine the factors that were significant in predicting a patient's prognosis, univariate and multivariate analyses were performed according to the Cox proportional hazards regression model.
  
  
  RESULTS
  The 5-year cancer specific survival (CSS) rate was 62.4% of patients with preoperative fibrinogen levels below 340 mg/dl and 41.9% for those with higher levels (p = 0.001). Multivariate analysis revealed that the pathological T stage (p < 0.001), tumor grade (p = 0.036), postoperative chemotherapy (p = 0.041), nodal metastasis(p < 0.001), pathological type (p < 0.001) and fibrinogen (p = 0.023) were independent prognostic factors for survival. Patients with low fibrinogen level (<340mg/dl) had significantly longer CSS and the different survival rate were defined using the log-rank test.
  
  
  CONCLUSIONS
  The high preoperative peripheral serum fibrinogen level was related to poor survival in penile cancer patients. Fibrinogen may serve as a powerful predictor of CSS in penile cancer patients.
authors.affiliation: Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China.
authors.forename: Chengquan
authors.initials: C
authors.lastname: Ma
authors.affiliation: Department of Operation Room, The Second Hospital of Tianjin Medical University, Tianjin, China.
authors.forename: Yaguang
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Urology, Jixian People's Hospital, Tianjin, China.
authors.forename: Sufen
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Tianjin institute of Urology,The Second Hospital of Tianjin Medical University, Tianjin, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Zhao
authors.affiliation: Department of Urology,Tianjin Nankai Hospital, Tianjin, China.
authors.forename: Bingxin
authors.initials: B
authors.lastname: Lu
authors.affiliation: Tianjin institute of Urology,The Second Hospital of Tianjin Medical University, Tianjin, China.
authors.forename: Erlin
authors.initials: E
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D015992:Body Mass Index; D005340:Fibrinogen / Q000032:analysis*; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010412:Penile Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000601:surgery; D057234:Preoperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D005340:Fibrinogen
keywords: biomarker; fibrinogen; penile cancer; prognosis; survival