Prognostic Impact of Plasma Fibrinogen Changing in Patients with Resectable Pancreatic Cancer

Original Article
Introduction: Previous studies have indicated that hyperfibrinogenemia is a predictor of poor prognosis in various tumors. However, little information is available on the prognostic impact of preoperative hyperfibrinogenemia and its changing pattern in resectable pancreatic ductal adenocarcinoma (PDAC) patients. Methods: This retrospective study examined 102 PDAC patients who underwent curative surgery at Omori Medical Center, Toho University School of Medicine (Tokyo, Japan) between 2004 and 2016. Among these, 44 (43.1%) reported preoperative hyperfibrinogenemia. Results: Preoperative hyperfibrinogenemia was associated with an independent prognostic factor for patient survival. The cumulative 5-year overall survival time rate in the normal fibrinogen and hyperfibrinogen groups was 44.8% and 31.2%, respectively, with a significant difference between the two groups (P = 0.047). The prognostic factors in PDAC patients revealed preoperative hyperfibrinogenemia of 〓400 mg/dL (P = 0.017). The cumulative 5-year overall survival rates were 57.3% and 9.1% in the normalization and non-normalization groups, respectively, with a significant difference between the two groups (P = 0.008). In multivariate analysis, the prognostic factors in patients with preoperative hyperfibrinogenemia revealed a postoperative fibrinogen level of 〓400 mg/dL (P = 0.001). Conclusions: Preoperative hyperfibrinogenemia was the risk factor for reducing overall survival in PDAC patients. Among the patients with hyperfibrinogenemia, the non-normalization group after surgery revealed to be a high-risk group for poor prognosis.