Prognostic value of plasma fibrinogen and d-dimer levels in patients with surgically resected non-small cell lung cancer

Abstract

Purpose A high plasma level of either fibrinogen or d-dimer has been shown to correlate with a poor prognosis in patients with surgically resected non-small-cell lung cancer (NSCLC). The present study aimed to identify whether or not both markers combined had a superior prognostic value to either alone. Methods Of the 1344 patients who underwent surgical resection for NSCLC at our institution between January 2007 and December 2016, 1065 had preoperative plasma fibrinogen and d-dimer data available and were included in the analysis. Results The recurrence-free survival (RFS) and overall survival (OS) rates were similar for patients with high plasma levels of either or both fibrinogen (> 4.0 g/L) or d-dimer (> 1.0 mu g/mL); therefore, these three groups were combined for a further analysis into a single group with high plasma levels of either or both proteins. The high-level group had significantly lower 5-year RFS (53% vs. 68%, p < 0.001) and 5-year OS (65% vs. 80%, p < 0.001) rates than patients with normal plasma levels of fibrinogen and d-dimer (control group). Conclusions Our results suggest that preoperative tests for both plasma fibrinogen and d-dimer are necessary to identify patients with surgically resected NSCLC likely to have a poor RFS and OS.