Xing Li1, Kunpeng Shu2, Jun Zhou3, Qian Yu3, Shaowei Cui3, Jianjun Liu2, Ruijin Zhou2, Degang Ding4. 1. Department of Urology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China. 2. Department of Urology, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China. 3. Department of Urology, Henan Provincial People's Hospital of Henan University, Zhengzhou, Henan, China. 4. Department of Urology, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China. Electronic address: 13503848199@163.com.
Abstract
PURPOSE: To assess the ability of preoperative plasma fibrinogen and D-dimer as biomarkers to predict survival outcomes in patients with non-muscle-invasive bladder cancer (NMIBC). PATIENTS AND METHODS: A total of 206 NMIBC patients receiving transurethral resection of bladder tumor (TURBT) were assessed in our retrospective study. The cutoff values of fibrinogen and D-dimer were determined using receiver operating characteristic curve analysis. Cox regression analyses were adopted to assess the influence of these two parameters on recurrence-free survival (RFS) and progression-free survival (PFS). RESULTS: The cutoff values of fibrinogen and D-dimer were 3.56 g/L and 0.48 μg/mL, respectively. Kaplan-Meier analysis demonstrated that high fibrinogen and D-dimer levels were significantly related to poor RFS (all P < .001) and PFS (all P < .001). Moreover, patients with elevated fibrinogen levels tended to have high tumor grade (P = .033), advanced pathologic T stage (P < .001), and multiple tumor lesions (P = .019). Significant associations of high D-dimer levels with advanced pathologic T stage (P = .026), large tumor size (P = .012), and multiple tumor lesions (P = .006) were found. In addition, multivariate analysis revealed that plasma fibrinogen and D-dimer were all independent predictive factors for RFS (P = .029 and .001, respectively) and PFS (P = .023 and .003, respectively). CONCLUSION: High levels of preoperative plasma fibrinogen and D-dimer may indicate advanced clinicopathologic features and worse prognosis, suggesting that these two coagulation parameters could be used as prognostic biomarkers for NMIBC patients.
PURPOSE: To assess the ability of preoperative plasma fibrinogen and D-dimer as biomarkers to predict survival outcomes in patients with non-muscle-invasive bladder cancer (NMIBC). PATIENTS AND METHODS: A total of 206 NMIBC patients receiving transurethral resection of bladder tumor (TURBT) were assessed in our retrospective study. The cutoff values of fibrinogen and D-dimer were determined using receiver operating characteristic curve analysis. Cox regression analyses were adopted to assess the influence of these two parameters on recurrence-free survival (RFS) and progression-free survival (PFS). RESULTS: The cutoff values of fibrinogen and D-dimer were 3.56 g/L and 0.48 μg/mL, respectively. Kaplan-Meier analysis demonstrated that high fibrinogen and D-dimer levels were significantly related to poor RFS (all P < .001) and PFS (all P < .001). Moreover, patients with elevated fibrinogen levels tended to have high tumor grade (P = .033), advanced pathologic T stage (P < .001), and multiple tumor lesions (P = .019). Significant associations of high D-dimer levels with advanced pathologic T stage (P = .026), large tumor size (P = .012), and multiple tumor lesions (P = .006) were found. In addition, multivariate analysis revealed that plasma fibrinogen and D-dimer were all independent predictive factors for RFS (P = .029 and .001, respectively) and PFS (P = .023 and .003, respectively). CONCLUSION: High levels of preoperative plasma fibrinogen and D-dimer may indicate advanced clinicopathologic features and worse prognosis, suggesting that these two coagulation parameters could be used as prognostic biomarkers for NMIBC patients.