doi:10.1186/s12301-023-00350-w...
Springer
Urology
2023
4/5/2023
Background We aimed to evaluate the role of plasma fibrinogen and D-dimer as prognostic biomarkers in patients with non-muscle invasive bladder cancer (NMIBC).
Methods The prospective study included 35 patients (30 males) with newly diagnosed NMIBC with no history of thromboembolic event or anti-coagulant intake or active infection and underwent complete trans-urethral resection between September 2020 and December 2021.
Patients with deranged hepato-renal functions, refractory hypertension or diagnosed with COVID-19 infection with in one-month before surgery or routine follow-up were excluded.
Follow-up was done as per NCCN guidelines.
Fibrinogen and D-dimer levels were measured with in seven days of surgery or follow-up and analyzed for recurrence-free survival (RFS) and progression-free survival (PFS).
Cox regression analyses were adopted to assess the influence of these two parameters on RFS and PFS.
Results The mean age was 53.9 years with a median follow-up of 9-months.
Nine had recurrence of which six had progression.
The cut-off values of fibrinogen and D-dimer were 402.5 mg/dl and 0.55 µg/ml, respectively.
Kaplan–Meier analysis demonstrated that high fibrinogen and D-dimer levels were significantly related to poor RFS and PFS ( p < 0.001).
On multivariate analysis only fibrinogen and D-dimer retained their significance for RFS ( p = 0.026 and 0.014, respectively) and PFS ( p = 0.027 and 0.042, respectively).
High levels of fibrinogen and D-dimer were also present in patients who had recurrence or progression at follow-up visits compared to rest of the patients.
Conclusions High levels of fibrinogen and D-dimer may indicate worse prognosis in patients with NMIBC, suggesting that these two can be used as prognostic biomarkers.
Singla, Sahil,Goel, Apul,Mishra, Sanjay,Lohani, Ravi,Sankhwar, Satya Narayan,Singh, Sashi Raj, 2023, Role of plasma fibrinogen and D-dimer as prognostic biomarkers in patients with non-muscle invasive bladder cancer, Springer