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Pretreatment elevated fibrinogen level predicts worse oncologic outcomes in upper tract urothelial carcinoma

التفاصيل البيبلوغرافية
العنوان: Pretreatment elevated fibrinogen level predicts worse oncologic outcomes in upper tract urothelial carcinoma
المؤلفون: Hang Xu, Jian-Zhong Ai, Ping Tan, Tian-Hai Lin, Xi Jin, Li-Na Gong, Hao-Ran Lei, Lu Yang, Qiang Wei
المصدر: Asian Journal of Andrology, Vol 22, Iss 2, Pp 177-183 (2020)
بيانات النشر: Wolters Kluwer Medknow Publications, 2020.
سنة النشر: 2020
المجموعة: LCC:Diseases of the genitourinary system. Urology
مصطلحات موضوعية: fibrinogen, prognosis, radical nephroureterectomy, upper tract urothelial carcinoma, Diseases of the genitourinary system. Urology, RC870-923
الوصف: This study aimed to further validate the prognostic role of fibrinogen in upper tract urothelial carcinoma (UTUC) in a large Chinese cohort. A total of 703 patients who underwent radical nephroureterectomy were retrospectively identified. Fibrinogen levels of ≥4.025 g l−1 were defined as elevated. Logistic regression analysis was performed to determine the association between fibrinogen and adverse pathological features. Kaplan–Meier analysis and Cox regression models were used to assess the associations of fibrinogen with cancer-specific survival (CSS), disease recurrence-free survival (RFS), and overall survival (OS). Harrell c-index and decision curve analysis were used to assess the clinical utility of multivariate models. The median follow-up duration was 42 (range: 1–168) months. Logistic regression analysis revealed that elevated fibrinogen was associated with higher tumor stage and grade, lymph node involvement, lymphovascular invasion, sessile carcinoma, concomitant variant histology, and positive surgical margins (all P < 0.05). Multivariate Cox regression analysis demonstrated that elevated fibrinogen was independently associated with decreased CSS (hazard ratio [HR]: 2.33; P < 0.001), RFS (HR: 2.09; P < 0.001), and OS (HR: 2.09; P < 0.001). The predictive accuracies of the multivariate models were improved by 3.2%, 2.0%, and 2.8% for CSS, RFS, and OS, respectively, when fibrinogen was added. Decision curve analysis showed an added benefit for CSS prediction when fibrinogen was added to the model. Preoperative fibrinogen may be a strong independent predictor of worse oncologic outcomes in UTUC; therefore, it may be valuable to apply this marker to the current risk stratification in UTUC.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1008-682X
1745-7262
Relation: http://www.ajandrology.com/article.asp?issn=1008-682X;year=2020;volume=22;issue=2;spage=177;epage=183;aulast=Xu; https://doaj.org/toc/1008-682X; https://doaj.org/toc/1745-7262
DOI: 10.4103/aja.aja_38_19
URL الوصول: https://doaj.org/article/5d8083ae4a934fef916fe38862144da1
رقم الأكسشن: edsdoj.5d8083ae4a934fef916fe38862144da1
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:1008682X
17457262
DOI:10.4103/aja.aja_38_19