Serum Fibrinogen Is An Independent Prognostic Factor In Operable Esophageal Squamous Carcinoma: A Real-World Study

PURPOSE: To fully elucidate the relationship of serum fibrinogen and the prognosis of esophageal squamous cell carcinoma. METHODS: The concentrations of serum fibrinogen were measured by the Clauss method in a total of 1331 operable esophageal squamous cell carcinoma (ESCC) patients from the past 3 years. The correlation of serum fibrinogen concentration and patient outcome and clinical pathological factors was tested. RESULTS: Hyperfibrinogenemia was significantly correlated with advanced pathological T stage and TNM stage. Serum fibrinogen was determined as a worse independent survival predictor in ESCC by survival analysis. The hazard ratio was 1.672 (95% confidence interval [CI] 1.043–2.681). A subgroup analysis further elucidated a significant correlation between hyperfibrinogenemia and younger age (P=0.011), being female (P=0.002), not having a history of smoking (p<0.001) or alcohol consumption (p<0.001), pathological N0 stage (P=0.002), and early pathological TNM stage (I-II) (P=0.004). CONCLUSION: This research showed that preoperative serum fibrinogen is an independent prognostic factor for survival in ESCC, especially for the early pathological TNM stage (I-II) and N0 patients.