Predictive value of preoperative plasma fibrinogen and serum albumin score for postoperative survival of hepatocellular carcinoma after hepatectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Zhengzuo , LI Hui ,  WU Hong

Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WU Hong, Email: wuhong7801@163.com

Keywords：

hepatocellular carcinoma; fibrinogen; albumin; prognostic index; prognosis

DOI：

10.7507/1007-9424.202005112

Video：

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Objective To investigate the predictive value of preoperative plasma fibrinogen and serum albumin score (FA score) for postoperative survival of hepatocellular carcinoma (HCC) after hepatectomy.Method We retrospectively analyzed the clinicopathological data and follow-up information of 275 patients with HCC who underwent hepatectomy in West China Hospital of Sichuan University from March 2009 to December 2013.Results There’s no statistically significant difference in gender, ALT, total bilirubin, hepatitis B virus surface antigens, AFP, cirrhosis, macrovascular invasion, tumor differentiation, TNM stage, and postoperative adjuvant transarterial chemoembolization of HCC patients between FA score of 0 group and FA score of 1 and 2 group (P>0.05). There’s statistically significant difference in age, AST, tumor size, tumor number, microvascular invasion, and BCLC stage (P<0.05). Multivariate Cox proportional hazard regression analyses revealed that FA score (1 and 2) was an independent risk factor for HCC patients’ overall survival rate [HR=1.632, 95%CI was (1.141, 2.335), P=0.007] and early recurrence-free survival rate [HR=1.678, 95%CI was (1.083, 2.598), P=0.021], the overall survival rate and early recurrence free survival rate of HCC patients with FA score of 0 group were better than those of patients with FA score of 1 and2 group.Conclusions The preoperative FA score has a good prognostic value for survival of HCC patients who underwent hepatectomy. Preoperative FA score of 1 and 2 is an independent risk factor for overall survival rate and early recurrence free survival rate of HCC patients after hepatectomy.

Citation： LI Zhengzuo, LI Hui, WU Hong. Predictive value of preoperative plasma fibrinogen and serum albumin score for postoperative survival of hepatocellular carcinoma after hepatectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(2): 181-188. doi: 10.7507/1007-9424.202005112 Copy

1.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3.	Hasegawa K, Kokudo N, Makuuchi M, et al. Comparison of resection and ablation for hepatocellular carcinoma: a cohort study based on a Japanese nationwide survey. J Hepatol, 2013, 58(4): 724-729.
4.	Huang G, Jiang H, Lin Y, et al. Prognostic value of plasma fibrinogen in hepatocellular carcinoma: a meta-analysis. Cancer Manag Res, 2018, 10: 5027-5041.
5.	Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J, 2010, 9: 69.
6.	Wu M, Pan Y, Jia Z, et al. Preoperative plasma fibrinogen and serum albumin score is an independent prognostic factor for resectable stage Ⅱ-Ⅲ gastric cancer. Dis Markers, 2019, 2019: 9060845.
7.	Sun SY, Chen PP, Meng LX, et al. High preoperative plasma fibrinogen and serum albumin score is associated with poor survival in operable esophageal squamous cell carcinoma. Dis Esophagus, 2019, 32(1): 1-9.
8.	Li Y, Yang JN, Cheng SS, et al. Prognostic significance of FA score based on plasma fibrinogen and serum albumin in patients with epithelial ovarian cancer. Cancer Manag Res, 2019, 11: 7697-7705.
9.	中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌诊疗规范 (2019年版). 中华肝脏病杂志, 2020, 28(2): 112-128.
10.	Xu Q, Yan Y, Gu S, et al. A novel inflammation-based prognostic score: the fibrinogen/albumin ratio predicts prognoses of patients after curative resection for hepatocellular carcinoma. J Immunol Res, 2018, 2018: 4925498.
11.	Portolani N, Coniglio A, Ghidoni S, et al. Early and late recurrence after liver resection for hepatocellular carcinoma: prognostic and therapeutic implications. Ann Surg, 2006, 243(2): 229-235.
12.	Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet, 2001, 357(9255): 539-545.
13.	Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell, 2010, 140(6): 883-899.
14.	Mano Y, Shirabe K, Yamashita Y, et al. Preoperative neutrophil-to-lymphocyte ratio is a predictor of survival after hepatectomy for hepatocellular carcinoma: a retrospective analysis. Ann Surg, 2013, 258(2): 301-305.
15.	Zhao Y, Si G, Zhu F, et al. Prognostic role of platelet to lymphocyte ratio in hepatocellular carcinoma: a systematic review and meta-analysis. Oncotarget, 2017, 8(14): 22854-22862.
16.	Lin ZX, Ruan DY, Li Y, et al. Lymphocyte-to-monocyte ratio predicts survival of patients with hepatocellular carcinoma after curative resection. World J Gastroenterol, 2015, 21(38): 10898-10906.
17.	Kinoshita A, Onoda H, Imai N, et al. The Glasgow Prognostic Score, an inflammation based prognostic score, predicts survival in patients with hepatocellular carcinoma. BMC Cancer, 2013, 13: 52.
18.	Pinato DJ, Stebbing J, Ishizuka M, et al. A novel and validated prognostic index in hepatocellular carcinoma: the inflammation based index (IBI). J Hepatol, 2012, 57(5): 1013-1020.
19.	Bruix J, Reig M, Sherman M. Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma. Gastroenterology, 2016, 150(4): 835-853.
20.	Staton CA, Brown NJ, Lewis CE. The role of fibrinogen and related fragments in tumour angiogenesis and metastasis. Expert Opin Biol Ther, 2003, 3(7): 1105-1120.
21.	Sahni A, Simpson-Haidaris PJ, Sahni SK, et al. Fibrinogen synthesized by cancer cells augments the proliferative effect of fibroblast growth factor-2 (FGF-2). J Thromb Haemost, 2008, 6(1): 176-183.
22.	Sahni A, Francis CW. Vascular endothelial growth factor binds to fibrinogen and fibrin and stimulates endothelial cell proliferation. Blood, 2000, 96(12): 3772-3778.
23.	Steinbrecher KA, Horowitz NA, Blevins EA, et al. Colitis-associated cancer is dependent on the interplay between the hemostatic and inflammatory systems and supported by integrin alpha(M)beta(2) engagement of fibrinogen. Cancer Res, 2010, 70(7): 2634-2643.
24.	Zheng S, Shen J, Jiao Y, et al. Platelets and fibrinogen facilitate each other in protecting tumor cells from natural killer cytotoxicity. Cancer Sci, 2009, 100(5): 859-865.
25.	Palumbo JS, Talmage KE, Massari JV, et al. Platelets and fibrin(ogen) increase metastatic potential by impeding natural killer cell-mediated elimination of tumor cells. Blood, 2005, 105(1): 178-185.
26.	Perisanidis C, Psyrri A, Cohen EE, et al. Prognostic role of pretreatment plasma fibrinogen in patients with solid tumors: a systematic review and meta-analysis. Cancer Treat Rev, 2015, 41(10): 960-970.
27.	Xu HJ, Ma Y, Deng F, et al. The prognostic value of C-reactive protein/albumin ratio in human malignancies: an updated meta-analysis. Onco Targets Ther, 2017, 10: 3059-3070.
28.	McMillan DC, Watson WS, O’Gorman P, et al. Albumin concentrations are primarily determined by the body cell mass and the systemic inflammatory response in cancer patients with weight loss. Nutr Cancer, 2001, 39(2): 210-213.
29.	Van Cutsem E, Arends J. The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs, 2005, 9(Suppl 2): S51-S63.
30.	Seaton K. Albumin concentration controls cancer. J Natl Med Assoc, 2001, 93(12): 490-493.
31.	Chen Z, Shao Y, Wang K, et al. Prognostic role of pretreatment serum albumin in renal cell carcinoma: a systematic review and meta-analysis. Onco Targets Ther, 2016, 9: 6701-6710.
32.	Danan D, Shonka DC Jr, Selman Y, et al. Prognostic value of albumin in patients with head and neck cancer. Laryngoscope, 2016, 126(7): 1567-1571.
33.	Espinosa E, Feliu J, Zamora P, et al. Serum albumin and other prognostic factors related to response and survival in patients with advanced non-small cell lung cancer. Lung Cancer, 1995, 12(1-2): 67-76.
34.	Asher V, Lee J, Bali A. Preoperative serum albumin is an independent prognostic predictor of survival in ovarian cancer. Med Oncol, 2012, 29(3): 2005-2009.
35.	Cho YK, Chung JW, Kim JK, et al. Comparison of 7 staging systems for patients with hepatocellular carcinoma undergoing transarterial chemoembolization. Cancer, 2008, 112(2): 352-361.
36.	Matsuda S, Takeuchi H, Kawakubo H, et al. Cumulative prognostic scores based on plasma fibrinogen and serum albumin levels in esophageal cancer patients treated with transthoracic esophagectomy: comparison with the Glasgow prognostic score. Ann Surg Oncol, 2015, 22(1): 302-310.
37.	Chen P, Wang C, Cheng B, et al. Plasma fibrinogen and serum albumin levels (FA score) act as a promising prognostic indicator in non-small cell lung cancer. Onco Targets Ther, 2017, 10: 3107-3118.
38.	Imamura H, Matsuyama Y, Tanaka E, et al. Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. J Hepatol, 2003, 38(2): 200-207.
39.	Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res, 2014, 20(23): 6212-6222.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3. Hasegawa K, Kokudo N, Makuuchi M, et al. Comparison of resection and ablation for hepatocellular carcinoma: a cohort study based on a Japanese nationwide survey. J Hepatol, 2013, 58(4): 724-729.
4. Huang G, Jiang H, Lin Y, et al. Prognostic value of plasma fibrinogen in hepatocellular carcinoma: a meta-analysis. Cancer Manag Res, 2018, 10: 5027-5041.
5. Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J, 2010, 9: 69.
6. Wu M, Pan Y, Jia Z, et al. Preoperative plasma fibrinogen and serum albumin score is an independent prognostic factor for resectable stage Ⅱ-Ⅲ gastric cancer. Dis Markers, 2019, 2019: 9060845.
7. Sun SY, Chen PP, Meng LX, et al. High preoperative plasma fibrinogen and serum albumin score is associated with poor survival in operable esophageal squamous cell carcinoma. Dis Esophagus, 2019, 32(1): 1-9.
8. Li Y, Yang JN, Cheng SS, et al. Prognostic significance of FA score based on plasma fibrinogen and serum albumin in patients with epithelial ovarian cancer. Cancer Manag Res, 2019, 11: 7697-7705.
9. 中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌诊疗规范 (2019年版). 中华肝脏病杂志, 2020, 28(2): 112-128.
10. Xu Q, Yan Y, Gu S, et al. A novel inflammation-based prognostic score: the fibrinogen/albumin ratio predicts prognoses of patients after curative resection for hepatocellular carcinoma. J Immunol Res, 2018, 2018: 4925498.
11. Portolani N, Coniglio A, Ghidoni S, et al. Early and late recurrence after liver resection for hepatocellular carcinoma: prognostic and therapeutic implications. Ann Surg, 2006, 243(2): 229-235.
12. Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet, 2001, 357(9255): 539-545.
13. Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell, 2010, 140(6): 883-899.
14. Mano Y, Shirabe K, Yamashita Y, et al. Preoperative neutrophil-to-lymphocyte ratio is a predictor of survival after hepatectomy for hepatocellular carcinoma: a retrospective analysis. Ann Surg, 2013, 258(2): 301-305.
15. Zhao Y, Si G, Zhu F, et al. Prognostic role of platelet to lymphocyte ratio in hepatocellular carcinoma: a systematic review and meta-analysis. Oncotarget, 2017, 8(14): 22854-22862.
16. Lin ZX, Ruan DY, Li Y, et al. Lymphocyte-to-monocyte ratio predicts survival of patients with hepatocellular carcinoma after curative resection. World J Gastroenterol, 2015, 21(38): 10898-10906.
17. Kinoshita A, Onoda H, Imai N, et al. The Glasgow Prognostic Score, an inflammation based prognostic score, predicts survival in patients with hepatocellular carcinoma. BMC Cancer, 2013, 13: 52.
18. Pinato DJ, Stebbing J, Ishizuka M, et al. A novel and validated prognostic index in hepatocellular carcinoma: the inflammation based index (IBI). J Hepatol, 2012, 57(5): 1013-1020.
19. Bruix J, Reig M, Sherman M. Evidence-based diagnosis, staging, and treatment of patients with hepatocellular carcinoma. Gastroenterology, 2016, 150(4): 835-853.
20. Staton CA, Brown NJ, Lewis CE. The role of fibrinogen and related fragments in tumour angiogenesis and metastasis. Expert Opin Biol Ther, 2003, 3(7): 1105-1120.
21. Sahni A, Simpson-Haidaris PJ, Sahni SK, et al. Fibrinogen synthesized by cancer cells augments the proliferative effect of fibroblast growth factor-2 (FGF-2). J Thromb Haemost, 2008, 6(1): 176-183.
22. Sahni A, Francis CW. Vascular endothelial growth factor binds to fibrinogen and fibrin and stimulates endothelial cell proliferation. Blood, 2000, 96(12): 3772-3778.
23. Steinbrecher KA, Horowitz NA, Blevins EA, et al. Colitis-associated cancer is dependent on the interplay between the hemostatic and inflammatory systems and supported by integrin alpha(M)beta(2) engagement of fibrinogen. Cancer Res, 2010, 70(7): 2634-2643.
24. Zheng S, Shen J, Jiao Y, et al. Platelets and fibrinogen facilitate each other in protecting tumor cells from natural killer cytotoxicity. Cancer Sci, 2009, 100(5): 859-865.
25. Palumbo JS, Talmage KE, Massari JV, et al. Platelets and fibrin(ogen) increase metastatic potential by impeding natural killer cell-mediated elimination of tumor cells. Blood, 2005, 105(1): 178-185.
26. Perisanidis C, Psyrri A, Cohen EE, et al. Prognostic role of pretreatment plasma fibrinogen in patients with solid tumors: a systematic review and meta-analysis. Cancer Treat Rev, 2015, 41(10): 960-970.
27. Xu HJ, Ma Y, Deng F, et al. The prognostic value of C-reactive protein/albumin ratio in human malignancies: an updated meta-analysis. Onco Targets Ther, 2017, 10: 3059-3070.
28. McMillan DC, Watson WS, O’Gorman P, et al. Albumin concentrations are primarily determined by the body cell mass and the systemic inflammatory response in cancer patients with weight loss. Nutr Cancer, 2001, 39(2): 210-213.
29. Van Cutsem E, Arends J. The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs, 2005, 9(Suppl 2): S51-S63.
30. Seaton K. Albumin concentration controls cancer. J Natl Med Assoc, 2001, 93(12): 490-493.
31. Chen Z, Shao Y, Wang K, et al. Prognostic role of pretreatment serum albumin in renal cell carcinoma: a systematic review and meta-analysis. Onco Targets Ther, 2016, 9: 6701-6710.
32. Danan D, Shonka DC Jr, Selman Y, et al. Prognostic value of albumin in patients with head and neck cancer. Laryngoscope, 2016, 126(7): 1567-1571.
33. Espinosa E, Feliu J, Zamora P, et al. Serum albumin and other prognostic factors related to response and survival in patients with advanced non-small cell lung cancer. Lung Cancer, 1995, 12(1-2): 67-76.
34. Asher V, Lee J, Bali A. Preoperative serum albumin is an independent prognostic predictor of survival in ovarian cancer. Med Oncol, 2012, 29(3): 2005-2009.
35. Cho YK, Chung JW, Kim JK, et al. Comparison of 7 staging systems for patients with hepatocellular carcinoma undergoing transarterial chemoembolization. Cancer, 2008, 112(2): 352-361.
36. Matsuda S, Takeuchi H, Kawakubo H, et al. Cumulative prognostic scores based on plasma fibrinogen and serum albumin levels in esophageal cancer patients treated with transthoracic esophagectomy: comparison with the Glasgow prognostic score. Ann Surg Oncol, 2015, 22(1): 302-310.
37. Chen P, Wang C, Cheng B, et al. Plasma fibrinogen and serum albumin levels (FA score) act as a promising prognostic indicator in non-small cell lung cancer. Onco Targets Ther, 2017, 10: 3107-3118.
38. Imamura H, Matsuyama Y, Tanaka E, et al. Risk factors contributing to early and late phase intrahepatic recurrence of hepatocellular carcinoma after hepatectomy. J Hepatol, 2003, 38(2): 200-207.
39. Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res, 2014, 20(23): 6212-6222.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Predictive value of preoperative plasma fibrinogen and serum albumin score for postoperative survival of hepatocellular carcinoma after hepatectomy

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