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Gynecologic Oncology

Plasma Fibrinogen Levels and Prognosis in Patients with Ovarian Cancer: A Multicenter Study

^aDepartment of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria; ^bDepartment of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria; ^cDepartment of Obstetrics and Gynecology, Landeskrankenhaus Klagenfurt, Klagenfurt, Austria

Key Words. Fibrinogen • Ovarian cancer • Prognosis • Inflammation • Plasma

Correspondence: Stephan Polterauer, M.D., Department of Obstetrics & Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria, Telephone: 43-1-40400-2962; Fax: 43-1-40400-2911; e-mail: stephan.polterauer{at}meduniwien.ac.at

Received April 20, 2009; accepted for publication August 29, 2009; first published online in THE ONCOLOGIST Express on September 23, 2009.

Disclosures

Stephan Polterauer: None; Christoph Grimm: None; Veronika Seebacher: None; Nicole Concin: None; Christian Marth: None; Caroline Tomovski: None; Heinrich Husslein: None; Heinz Leipold: None; Katrin Hefler-Frischmuth: None; Clemens Tempfer: None; Alexander Reinthaller: None; Lukas Hefler: None.

Section editors Peter G. Harper and Dennis S. Chi have disclosed no financial relationships relevant to the content of this article.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias.

Introduction. To evaluate pretherapeutic plasma fibrinogen levels as a prognostic parameter in patients with epithelial ovarian cancer (EOC).

Materials and Methods. In the present multicenter study, pretherapeutic plasma fibrinogen levels were evaluated in 422 patients with EOC. Plasma fibrinogen levels were correlated with clinicopathological parameters and patient survival.

Results. The mean (standard deviation) pretherapeutic plasma fibrinogen level was 450.0 (150.1) mg/dl. Elevated plasma fibrinogen levels were associated with advanced tumor stage (p = .01) and the presence of a postoperative residual tumor mass (p < .001), but not with histological grade (p = .1) and histological type (p = .8). In a multivariate Cox regression model, tumor stage (p < .001 and p < .001), postoperative residual tumor mass (p = .001 and p = .008), and plasma fibrinogen level (p < .001 and p = .002), but not histological type (p = .8 and p = .2), patient age (p = .9 and p = .9), and serum cancer antigen 125 (p = 0.2 and p = 0.3) and C-reactive protein (p = .2 and p = .3) levels, were associated with disease-free and overall survival, respectively. Histological grade was associated with overall but not with disease-free survival (p = .01 and p = .8), respectively.

Conclusions. Pretherapeutic plasma fibrinogen levels can be used as an independent prognostic parameter in patients with EOC.