Impact of fibrinogen levels and modified Glasgow prognostic score on survival of stage III/N2 non-small cell lung cancer patients treated with neoadjuvant therapy and radical resection
Abstract Purpose The prognostic value of pretreatment and preoperative fibrinogen plasma levels and the modified Glasgow prognostic score (mGPS) in stage III/N2 non-small cell lung cancer (NSCLC) patients who receive neoadjuvant treatment followed by radical surgery is yet unclear. Methods Fibrinoge...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-022-10298-9 |
| _version_ | 1828094134784622592 |
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| author | Katharina Sinn Berta Mosleh Michael Grusch Walter Klepetko Konrad Hoetzenecker Thomas Klikovits Daniela Gompelmann Mir Alireza Hoda |
| author_facet | Katharina Sinn Berta Mosleh Michael Grusch Walter Klepetko Konrad Hoetzenecker Thomas Klikovits Daniela Gompelmann Mir Alireza Hoda |
| author_sort | Katharina Sinn |
| collection | DOAJ |
| description | Abstract Purpose The prognostic value of pretreatment and preoperative fibrinogen plasma levels and the modified Glasgow prognostic score (mGPS) in stage III/N2 non-small cell lung cancer (NSCLC) patients who receive neoadjuvant treatment followed by radical surgery is yet unclear. Methods Fibrinogen levels and mGPS of 84 patients with initial stage III/N2 NSCLC, who received neoadjuvant therapy followed by complete surgical resection from 2002 to 2014 were retrospectively analyzed and correlated with clinical parameters and overall survival (OS). Data were analyzed using log-rank and Cox regression analysis adjusted for clinical and pathological factors. Results Median serum fibrinogen level after neoadjuvant treatment was 439 mg/dL (IQR 158 mg/dL). Elevated fibrinogen levels (> 400 mg/dL) after neoadjuvant treatment were significantly associated with poorer OS (28.2 months vs. 60.9 months, HR 0.562, p = 0.048). Importantly, a decrease in fibrinogen levels after neoadjuvant treatment (n = 34) was found to be an independent predictor for favorable OS in multivariate analysis (HR 0.994, p = 0.025). Out of 80 patients, 55, 19 and 6 patients had a mGPS of 0, 1 and 2, respectively. Moreover, elevated mGPS after neoadjuvant treatment (mGPS 1–2) showed a non-significant trend for poorer OS compared to mGPS 0 (28.2 vs. 46.5 months, HR 0.587, p = 0.066). Conclusion Elevated fibrinogen levels after neoadjuvant therapy prior to surgery in stage III/N2 NSCLC patients are associated with significant disadvantage for OS. A decrease in fibrinogen levels after neoadjuvant therapy was found to be a predictor for superior OS in this retrospective patient cohort. |
| first_indexed | 2024-04-11T06:54:36Z |
| format | Article |
| id | doaj.art-6a01baa6d085447b92e3f4a36b327326 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-11T06:54:36Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-6a01baa6d085447b92e3f4a36b3273262022-12-22T04:39:04ZengBMCBMC Cancer1471-24072022-11-012211810.1186/s12885-022-10298-9Impact of fibrinogen levels and modified Glasgow prognostic score on survival of stage III/N2 non-small cell lung cancer patients treated with neoadjuvant therapy and radical resectionKatharina Sinn0Berta Mosleh1Michael Grusch2Walter Klepetko3Konrad Hoetzenecker4Thomas Klikovits5Daniela Gompelmann6Mir Alireza Hoda7Department of Thoracic Surgery, Comprehensive Cancer Center, Medical University of ViennaDepartment of Thoracic Surgery, Comprehensive Cancer Center, Medical University of ViennaCenter for Cancer Research, Medical University of ViennaDepartment of Thoracic Surgery, Comprehensive Cancer Center, Medical University of ViennaDepartment of Thoracic Surgery, Comprehensive Cancer Center, Medical University of ViennaDepartment of Thoracic Surgery, Comprehensive Cancer Center, Medical University of ViennaDepartment of Thoracic Surgery, Comprehensive Cancer Center, Medical University of ViennaDepartment of Thoracic Surgery, Comprehensive Cancer Center, Medical University of ViennaAbstract Purpose The prognostic value of pretreatment and preoperative fibrinogen plasma levels and the modified Glasgow prognostic score (mGPS) in stage III/N2 non-small cell lung cancer (NSCLC) patients who receive neoadjuvant treatment followed by radical surgery is yet unclear. Methods Fibrinogen levels and mGPS of 84 patients with initial stage III/N2 NSCLC, who received neoadjuvant therapy followed by complete surgical resection from 2002 to 2014 were retrospectively analyzed and correlated with clinical parameters and overall survival (OS). Data were analyzed using log-rank and Cox regression analysis adjusted for clinical and pathological factors. Results Median serum fibrinogen level after neoadjuvant treatment was 439 mg/dL (IQR 158 mg/dL). Elevated fibrinogen levels (> 400 mg/dL) after neoadjuvant treatment were significantly associated with poorer OS (28.2 months vs. 60.9 months, HR 0.562, p = 0.048). Importantly, a decrease in fibrinogen levels after neoadjuvant treatment (n = 34) was found to be an independent predictor for favorable OS in multivariate analysis (HR 0.994, p = 0.025). Out of 80 patients, 55, 19 and 6 patients had a mGPS of 0, 1 and 2, respectively. Moreover, elevated mGPS after neoadjuvant treatment (mGPS 1–2) showed a non-significant trend for poorer OS compared to mGPS 0 (28.2 vs. 46.5 months, HR 0.587, p = 0.066). Conclusion Elevated fibrinogen levels after neoadjuvant therapy prior to surgery in stage III/N2 NSCLC patients are associated with significant disadvantage for OS. A decrease in fibrinogen levels after neoadjuvant therapy was found to be a predictor for superior OS in this retrospective patient cohort.https://doi.org/10.1186/s12885-022-10298-9Non-small-cell lung cancerFibrinogenmGPSN2 diseaseStage III |
| spellingShingle | Katharina Sinn Berta Mosleh Michael Grusch Walter Klepetko Konrad Hoetzenecker Thomas Klikovits Daniela Gompelmann Mir Alireza Hoda Impact of fibrinogen levels and modified Glasgow prognostic score on survival of stage III/N2 non-small cell lung cancer patients treated with neoadjuvant therapy and radical resection BMC Cancer Non-small-cell lung cancer Fibrinogen mGPS N2 disease Stage III |
| title | Impact of fibrinogen levels and modified Glasgow prognostic score on survival of stage III/N2 non-small cell lung cancer patients treated with neoadjuvant therapy and radical resection |
| title_full | Impact of fibrinogen levels and modified Glasgow prognostic score on survival of stage III/N2 non-small cell lung cancer patients treated with neoadjuvant therapy and radical resection |
| title_fullStr | Impact of fibrinogen levels and modified Glasgow prognostic score on survival of stage III/N2 non-small cell lung cancer patients treated with neoadjuvant therapy and radical resection |
| title_full_unstemmed | Impact of fibrinogen levels and modified Glasgow prognostic score on survival of stage III/N2 non-small cell lung cancer patients treated with neoadjuvant therapy and radical resection |
| title_short | Impact of fibrinogen levels and modified Glasgow prognostic score on survival of stage III/N2 non-small cell lung cancer patients treated with neoadjuvant therapy and radical resection |
| title_sort | impact of fibrinogen levels and modified glasgow prognostic score on survival of stage iii n2 non small cell lung cancer patients treated with neoadjuvant therapy and radical resection |
| topic | Non-small-cell lung cancer Fibrinogen mGPS N2 disease Stage III |
| url | https://doi.org/10.1186/s12885-022-10298-9 |
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