title: A Novel Predictor of Survival with Renal Cell Carcinoma After Nephrectomy.
abstract: To validate plasma fibrinogen and serum cholesterol levels as prognostic factors for patients with renal cell carcinoma (RCC) and to explore the prognostic value of their combination.
  
  
  
  Medical data for 1360 RCC patients after nephrectomy were collected. X-tile software was used to determine the cutoff values. The association between clinicopathological factors and fibrinogen and cholesterol levels was determined, and factors predicting survival were examined by multivariate analysis.
  
  
  
  The median follow-up was 67 months (interquartile range 36-74 months). On univariate and multivariate analysis, both preoperative plasma fibrinogen and serum cholesterol were independent prognostic factors of cancer-specific survival (CSS) and progression-free survival (PFS). By combining the two factors, we developed a novel index, fibrinogen-cholesterol (FC) score and found it to have better prognostic accuracy than the two factors alone. FC was an independent prognostic factor for both CSS (FC score = 1: hazard ratio [HR] = 3.207, 95% confidence interval [CI] = 1.775-5.793; FC score = 2: HR = 5.516, 95% CI = 2.891-10.527) and PFS (FC score = 1: HR = 2.178, 95% CI = 1.545-3.071; FC score = 2: HR = 3.709, 95% CI = 2.355-5.840).
  
  
  
  Both preoperative plasma fibrinogen and serum cholesterol levels are independent prognostic factors for CSS and PFS in RCC patients after nephrectomy. A novel indicator, FC score, could be considered a novel preoperative prognostic index in RCC.
authors.affiliation: 1 Department of Urology, Peking University First Hospital , Beijing, China .|2 Institute of Urology, Peking University , Beijing, China .|3 National Urological Cancer Center , Beijing, China .|4 Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University , Beijing, China .
authors.forename: Ding
authors.initials: D
authors.lastname: Peng
authors.affiliation: 1 Department of Urology, Peking University First Hospital , Beijing, China .|2 Institute of Urology, Peking University , Beijing, China .|3 National Urological Cancer Center , Beijing, China .|4 Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University , Beijing, China .
authors.forename: Zhi-Song
authors.initials: ZS
authors.lastname: He
authors.affiliation: 1 Department of Urology, Peking University First Hospital , Beijing, China .|2 Institute of Urology, Peking University , Beijing, China .|3 National Urological Cancer Center , Beijing, China .|4 Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University , Beijing, China .
authors.forename: Xue-Song
authors.initials: XS
authors.lastname: Li
authors.affiliation: 1 Department of Urology, Peking University First Hospital , Beijing, China .|2 Institute of Urology, Peking University , Beijing, China .|3 National Urological Cancer Center , Beijing, China .|4 Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University , Beijing, China .
authors.forename: Qi
authors.initials: Q
authors.lastname: Tang
authors.affiliation: 1 Department of Urology, Peking University First Hospital , Beijing, China .|2 Institute of Urology, Peking University , Beijing, China .|3 National Urological Cancer Center , Beijing, China .|4 Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University , Beijing, China .
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: 1 Department of Urology, Peking University First Hospital , Beijing, China .|2 Institute of Urology, Peking University , Beijing, China .|3 National Urological Cancer Center , Beijing, China .|4 Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University , Beijing, China .
authors.forename: Kai-Wei
authors.initials: KW
authors.lastname: Yang
authors.affiliation: 1 Department of Urology, Peking University First Hospital , Beijing, China .|2 Institute of Urology, Peking University , Beijing, China .|3 National Urological Cancer Center , Beijing, China .|4 Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University , Beijing, China .
authors.forename: Xiao-Teng
authors.initials: XT
authors.lastname: Yu
authors.affiliation: 1 Department of Urology, Peking University First Hospital , Beijing, China .|2 Institute of Urology, Peking University , Beijing, China .|3 National Urological Cancer Center , Beijing, China .|4 Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University , Beijing, China .
authors.forename: Cui-Jian
authors.initials: CJ
authors.lastname: Zhang
authors.affiliation: 1 Department of Urology, Peking University First Hospital , Beijing, China .|2 Institute of Urology, Peking University , Beijing, China .|3 National Urological Cancer Center , Beijing, China .|4 Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University , Beijing, China .
authors.forename: Li-Qun
authors.initials: LQ
authors.lastname: Zhou
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002784:Cholesterol / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D007680:Kidney Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009392:Nephrectomy; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D005340:Fibrinogen; D002784:Cholesterol
keywords: cholesterol; fibrinogen; nephrectomy; prognosis; renal cell carcinoma