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Prognostic significance of preoperative plasma fibrinogen levels in primary gastrointestinal stromal tumours: a retrospective cohort study

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Abstract

Background

Improved prediction of prognosis for gastrointestinal stromal tumours (GISTs) has become increasingly important since the introduction of targeted therapy. Here, we aimed to evaluate the prognostic significance of preoperative plasma fibrinogen (Fib) levels in patients with primary GISTs and to analyse their correlations with clinicopathological characteristics.

Methods

A total of 201 previously untreated patients with primary GISTs who had undergone radical surgery at our institution between October 2004 and July 2018 were enrolled. The optimal cut-off value for Fib levels was calculated using time-dependent receiver-operating characteristic curve analysis. RFS, the primary endpoint, was calculated by the Kaplan–Meier method and compared by the log-rank test. Univariate and multivariate Cox regression models were calculated.

Results

High preoperative plasma Fib levels were detected as an independent adverse prognostic factor (p = 0.008, hazard ratio 3.136, 95% CI 1.356‒7.256). Furthermore, high preoperative plasma Fib levels also indicated a poor prognosis within the modified National Institutes of Health (mNIH) high-risk subgroup (p = 0.041). In addition, preoperative plasma Fib levels showed a positive correlation with several prognostic factors and even a linear relationship with tumour size (Spearman correlation coefficient [r] = 0.411, p < 0.001).

Conclusions

Our results suggest that high preoperative plasma Fib levels may indicate a poor prognosis in patients with primary GISTs. As a cost-effective biomarker, preoperative assessment of plasma Fib levels may help to further risk stratify patients with mNIH high-risk GISTs and instruct the application of targeted therapy.

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Acknowledgements

The authors are grateful to all medical staff of the Department of General Surgery, Beijing Hospital, for their contributions to follow-up and data collection.

Funding

Not applicable.

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Authors and Affiliations

  1. Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Science, No. 1 Dahua Road, Dongcheng District, Beijing, People’s Republic of China

    Shibo Song, Xianglong Cao, Maolin Hu, Qiuxia Yan, Jinghai Song, Hua Yang, Gang Zhao & Gang Xiao

  2. Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, People’s Republic of China

    Shibo Song

  3. Department of Gastric Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China

    Hongda Pan

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  1. Shibo Song
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  2. Xianglong Cao
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  3. Hongda Pan
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  4. Maolin Hu
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  5. Qiuxia Yan
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  6. Jinghai Song
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  7. Hua Yang
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  8. Gang Zhao
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  9. Gang Xiao
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Contributions

SBS designed the study, analysed the data, and wrote the manuscript. GX assisted in the study design, data interpretation, and revision. XLC, HDP, JHS, and GZ contributed to the study design and revision. MLH, QXY and HY contributed to the data collection and analysis. All authors read and approved the final manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Gang Xiao.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval and consent to participate

The study was approved by the Ethics Committee of Beijing Hospital with Approval Letter No. 2019BJYYEC-030-01 and was granted an exemption from requiring informed consent.

Data transparency

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Song, S., Cao, X., Pan, H. et al. Prognostic significance of preoperative plasma fibrinogen levels in primary gastrointestinal stromal tumours: a retrospective cohort study. Int J Clin Oncol 25, 1506–1514 (2020). https://doi.org/10.1007/s10147-020-01689-8

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  • DOI: https://doi.org/10.1007/s10147-020-01689-8

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