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- Title
Pre-therapeutic fibrinogen levels are of prognostic significance in locally advanced head and neck cancer.
- Authors
Selzer, Edgar; Grah, Anja; Heiduschka, Gregor; Kornek, Gabriela; Thurnher, Dietmar
- Abstract
Objectives: The objective of this retrospective study was to clarify the potential prognostic significance of pre-therapeutic fibrinogen levels in head and neck squamous cell carcinoma (HNSCC) patients treated with curative intent by primary radiotherapy (RT) or with postoperative radiotherapy (PORT). Patients and methods: We retrospectively analyzed data from 347 patients with histologically confirmed locally advanced HNSCC. Analysis was conducted separately for the patient collective treated with PORT ( N = 141; 85.1 % AJCC stage III/IV) and for patients treated with primary RT ( N = 206; 97.1 % AJCC stage III/IV). Kaplan Meier analyses as well as univariate and multivariate survival analyses were performed to identify factors associated with overall survival (OS). Results: The most relevant observation was that plasma fibrinogen levels were significantly associated with a reduction of overall survival rates. In the low-fibrinogen (below 411 mg/dL) postoperatively irradiated group, OS rates at 2 and 3 years were 86 and 83 %, and in the high-fibrinogen group 66 and 51 %, respectively. In the RT group with low fibrinogen levels, OS rates after 2 and 3 years were 74 and 53 %, and in the high-fibrinogen group 40 and 22 %, respectively. In multivariate analysis, elevated fibrinogen concentrations were associated with inferior OS in both the postoperatively (HR = 2.5; p = 0.001) as well as in the primarily irradiated (HR = 1.7; p = 0.003) group. Conclusions: We conclude from these results that elevated pre-therapeutic fibrinogen may serve as a biomarker associated with worsened prognosis in locally advanced head and neck cancer patients treated by either RT or surgery followed by adjuvant radiotherapy.
- Subjects
HEAD &; neck cancer treatment; SQUAMOUS cell carcinoma; FIBRINOGEN; BIOMARKERS; CANCER radiotherapy; ADJUVANT treatment of cancer; PROGNOSIS
- Publication
Wiener Klinische Wochenschrift, 2016, Vol 128, Issue 9/10, p320
- ISSN
0043-5325
- Publication type
Article
- DOI
10.1007/s00508-016-0963-3