Prognostic impact of pretreatment plasma fibrinogen in patients with locally advanced oral and oropharyngeal cancer

Daniel Holzinger, Ivan Danilovic, Rudolf Seemann, Gabriela Kornek, Johannes Engelmann, Robert Pillerstorff, Simone Holawe, Amanda Psyrri, Boban M. Erovic, D Gregory Farwell, Christos Perisanidis

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Abstract

Background: We aimed to determine the prognostic significance of pretreatment plasma fibrinigen in patients with oral and oropharyngeal squamous cell carcinoma (OOSCC). Methods: A cohort of 183 patients with locally advanced OOSCC receiving preoperative chemoradiotherapy was retrospectively examined. Using ROC curve analysis, a pretreatment plasma fibrinogen cutoff value of 447mg/dL was determined. The primary endpoints were overall survival and recurrence-free survival. A secondary endpoint was to determine whether pretreatment plasma fibrinogen could predict treatment response to neoadjuvant chemoradiotherapy. Cox regression models and Kaplan-Meier curves were used for survival analyses. Results: Seventy-one patients had an elevated pretreatment plasma fibrinogen (fibrinogen >447mg/dL). Patients with high fibrinogen showed significantly higher pathologic stages after neoadjuvant treatment than those with low fibrinogen (p = 0.037). In univariate analysis, elevated fibrinogen was associated with poor overall survival (p = 0.005) and recurrence-free survival (p = 0.008) Multivariate analysis revealed that elevated fibrinogen remained an independent risk factor for death (hazard ratio 1.78, 95% CI 1.09-2.90, p = 0.021) and relapse (hazard ratio 1.78, 95% CI 1.11-2.86, p = 0.016). Conclusion: Elevated pretreatment plasma fibrinogen is associated with lack of response to neoadjuvant chemoradiotherapy and reduced OS and RFS in patients with OOSCC. Thus, plasma fibrinogen may emerge as a novel prognostic indicator and a potential therapeutic target in OOSCC.

Original languageEnglish (US)
Article numbere0158697
JournalPLoS One
Volume11
Issue number6
DOIs
StatePublished - Jun 1 2016

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Oropharyngeal Neoplasms
Mouth Neoplasms
fibrinogen
Fibrinogen
pretreatment
Plasmas
Chemoradiotherapy
squamous cell carcinoma
Squamous Cell Carcinoma
Survival
endpoints
Recurrence
ROC Curve
Hazards
oropharyngeal neoplasms
mouth neoplasms
Neoadjuvant Therapy
relapse
Survival Analysis
Proportional Hazards Models

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Holzinger, D., Danilovic, I., Seemann, R., Kornek, G., Engelmann, J., Pillerstorff, R., ... Perisanidis, C. (2016). Prognostic impact of pretreatment plasma fibrinogen in patients with locally advanced oral and oropharyngeal cancer. PLoS One, 11(6), [e0158697]. https://doi.org/10.1371/journal.pone.0158697

Prognostic impact of pretreatment plasma fibrinogen in patients with locally advanced oral and oropharyngeal cancer. / Holzinger, Daniel; Danilovic, Ivan; Seemann, Rudolf; Kornek, Gabriela; Engelmann, Johannes; Pillerstorff, Robert; Holawe, Simone; Psyrri, Amanda; Erovic, Boban M.; Farwell, D Gregory; Perisanidis, Christos.

In: PLoS One, Vol. 11, No. 6, e0158697, 01.06.2016.

Research output: Contribution to journalArticle

Holzinger, D, Danilovic, I, Seemann, R, Kornek, G, Engelmann, J, Pillerstorff, R, Holawe, S, Psyrri, A, Erovic, BM, Farwell, DG & Perisanidis, C 2016, 'Prognostic impact of pretreatment plasma fibrinogen in patients with locally advanced oral and oropharyngeal cancer', PLoS One, vol. 11, no. 6, e0158697. https://doi.org/10.1371/journal.pone.0158697
Holzinger D, Danilovic I, Seemann R, Kornek G, Engelmann J, Pillerstorff R et al. Prognostic impact of pretreatment plasma fibrinogen in patients with locally advanced oral and oropharyngeal cancer. PLoS One. 2016 Jun 1;11(6). e0158697. https://doi.org/10.1371/journal.pone.0158697
Holzinger, Daniel ; Danilovic, Ivan ; Seemann, Rudolf ; Kornek, Gabriela ; Engelmann, Johannes ; Pillerstorff, Robert ; Holawe, Simone ; Psyrri, Amanda ; Erovic, Boban M. ; Farwell, D Gregory ; Perisanidis, Christos. / Prognostic impact of pretreatment plasma fibrinogen in patients with locally advanced oral and oropharyngeal cancer. In: PLoS One. 2016 ; Vol. 11, No. 6.
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abstract = "Background: We aimed to determine the prognostic significance of pretreatment plasma fibrinigen in patients with oral and oropharyngeal squamous cell carcinoma (OOSCC). Methods: A cohort of 183 patients with locally advanced OOSCC receiving preoperative chemoradiotherapy was retrospectively examined. Using ROC curve analysis, a pretreatment plasma fibrinogen cutoff value of 447mg/dL was determined. The primary endpoints were overall survival and recurrence-free survival. A secondary endpoint was to determine whether pretreatment plasma fibrinogen could predict treatment response to neoadjuvant chemoradiotherapy. Cox regression models and Kaplan-Meier curves were used for survival analyses. Results: Seventy-one patients had an elevated pretreatment plasma fibrinogen (fibrinogen >447mg/dL). Patients with high fibrinogen showed significantly higher pathologic stages after neoadjuvant treatment than those with low fibrinogen (p = 0.037). In univariate analysis, elevated fibrinogen was associated with poor overall survival (p = 0.005) and recurrence-free survival (p = 0.008) Multivariate analysis revealed that elevated fibrinogen remained an independent risk factor for death (hazard ratio 1.78, 95{\%} CI 1.09-2.90, p = 0.021) and relapse (hazard ratio 1.78, 95{\%} CI 1.11-2.86, p = 0.016). Conclusion: Elevated pretreatment plasma fibrinogen is associated with lack of response to neoadjuvant chemoradiotherapy and reduced OS and RFS in patients with OOSCC. Thus, plasma fibrinogen may emerge as a novel prognostic indicator and a potential therapeutic target in OOSCC.",
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AU - Danilovic, Ivan

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AU - Kornek, Gabriela

AU - Engelmann, Johannes

AU - Pillerstorff, Robert

AU - Holawe, Simone

AU - Psyrri, Amanda

AU - Erovic, Boban M.

AU - Farwell, D Gregory

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N2 - Background: We aimed to determine the prognostic significance of pretreatment plasma fibrinigen in patients with oral and oropharyngeal squamous cell carcinoma (OOSCC). Methods: A cohort of 183 patients with locally advanced OOSCC receiving preoperative chemoradiotherapy was retrospectively examined. Using ROC curve analysis, a pretreatment plasma fibrinogen cutoff value of 447mg/dL was determined. The primary endpoints were overall survival and recurrence-free survival. A secondary endpoint was to determine whether pretreatment plasma fibrinogen could predict treatment response to neoadjuvant chemoradiotherapy. Cox regression models and Kaplan-Meier curves were used for survival analyses. Results: Seventy-one patients had an elevated pretreatment plasma fibrinogen (fibrinogen >447mg/dL). Patients with high fibrinogen showed significantly higher pathologic stages after neoadjuvant treatment than those with low fibrinogen (p = 0.037). In univariate analysis, elevated fibrinogen was associated with poor overall survival (p = 0.005) and recurrence-free survival (p = 0.008) Multivariate analysis revealed that elevated fibrinogen remained an independent risk factor for death (hazard ratio 1.78, 95% CI 1.09-2.90, p = 0.021) and relapse (hazard ratio 1.78, 95% CI 1.11-2.86, p = 0.016). Conclusion: Elevated pretreatment plasma fibrinogen is associated with lack of response to neoadjuvant chemoradiotherapy and reduced OS and RFS in patients with OOSCC. Thus, plasma fibrinogen may emerge as a novel prognostic indicator and a potential therapeutic target in OOSCC.

AB - Background: We aimed to determine the prognostic significance of pretreatment plasma fibrinigen in patients with oral and oropharyngeal squamous cell carcinoma (OOSCC). Methods: A cohort of 183 patients with locally advanced OOSCC receiving preoperative chemoradiotherapy was retrospectively examined. Using ROC curve analysis, a pretreatment plasma fibrinogen cutoff value of 447mg/dL was determined. The primary endpoints were overall survival and recurrence-free survival. A secondary endpoint was to determine whether pretreatment plasma fibrinogen could predict treatment response to neoadjuvant chemoradiotherapy. Cox regression models and Kaplan-Meier curves were used for survival analyses. Results: Seventy-one patients had an elevated pretreatment plasma fibrinogen (fibrinogen >447mg/dL). Patients with high fibrinogen showed significantly higher pathologic stages after neoadjuvant treatment than those with low fibrinogen (p = 0.037). In univariate analysis, elevated fibrinogen was associated with poor overall survival (p = 0.005) and recurrence-free survival (p = 0.008) Multivariate analysis revealed that elevated fibrinogen remained an independent risk factor for death (hazard ratio 1.78, 95% CI 1.09-2.90, p = 0.021) and relapse (hazard ratio 1.78, 95% CI 1.11-2.86, p = 0.016). Conclusion: Elevated pretreatment plasma fibrinogen is associated with lack of response to neoadjuvant chemoradiotherapy and reduced OS and RFS in patients with OOSCC. Thus, plasma fibrinogen may emerge as a novel prognostic indicator and a potential therapeutic target in OOSCC.

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