Published online Nov 28, 2018. doi: 10.3748/wjg.v24.i44.5046
Peer-review started: August 17, 2018
First decision: October 14, 2018
Revised: October 27, 2018
Accepted: November 9, 2018
Article in press: November 9, 2018
Published online: November 28, 2018
To investigate the prognostic value of preoperative fibrinogen concentration (FIB) and D-dimer-fibrinogen ratio (DFR) in gastrointestinal stromal tumors (GISTs).
The purpose of this study was to retrospectively analyze 170 patients with GISTs who were admitted to our hospital from January 2010 to December 2015. The optimal cutoff values of related parameters were estimated by receiver operating characteristic (ROC) curve analysis. The recurrence free survival (RFS) rate was evaluated using Kaplan-Meier curves. Univariate analysis and multivariate Cox regression models were used to analyze the prognostic factors of GISTs. The relationship between the FIB, D-dimer, DFR, platelet count (PLT), and the clinicopathological features of GISTs was described by the chi-square test or nonparametric rank sum test (Mann-Whitney test).
In ROC analysis, the optimal cutoff values of FIB, D-dimer, DFR, and PLT were 3.24 g/L, 1.24 mg/L, 0.354, and 197.5 (× 109/L), respectively. Univariate analysis and the Kaplan-Meier survival curve showed that FIB, D-dimer, DFR, PLT, National Institutes of Health (NIH) risk category, tumor size, tumor location, and mitotic index were significantly relevant to the 3-year and 5-year survival rate of patients (P < 0.05). Cox multivariate regression analysis illustrated that FIB (RR: 0.108, 95%CI: 0.031-0.373), DFR (RR: 0.319, 95%CI: 0.131-0.777), and NIH risk category (RR: 0.166, 95%CI: 0.047-0.589) were independent prognostic factors of the RFS rate (P < 0. 05). Moreover, FIB, D-dimer, DFR, and PLT were correlated with the clinical features of GISTs.
FIB, D-dimer, DFR, and PLT are all related to the prognosis of GISTs. Moreover, FIB and DFR may be independent risk factors for predicting the prognosis of resectable GISTs.
Core tip: For patients with gastrointestinal stromal tumors (GISTs), postoperative recurrence and metastasis are the main factors affecting survival. Moreover, recurrence and metastasis mainly occur in moderate and high-risk patients. Therefore, it is necessary to screen these patients for adjuvant treatment at an early stage. Fibrinogen (FIB) and D-dimer were reported to be associated with the prognosis of many tumors. The purpose of this study was to investigate the value of preoperative FIB, D-dimer, the D-dimer-fibrinogen ratio (DFR), and platelets in the prognosis of GISTs. The results showed that FIB and DFR were independent risk factors for predicting the prognosis of primary resectable GIST.