685P - An elevated fibrinogen/CRP ratio predicts a remarkable survival advantage in patients with metastatic pancreatic cancer

Date 08 October 2016
Event ESMO 2016 Congress
Session Poster Display
Topics Pancreatic Cancer
Presenter Thomas Winder
Citation Annals of Oncology (2016) 27 (6): 207-242. 10.1093/annonc/mdw371
Authors T. Winder1, F. Posch2, E. Asamer2, M. Stotz2, A. Siebenhüner1, K. Schlick3, T. Magnes4, P. Samaras1, J. Szkandera2, P. Clavien5, D. Neureiter6, R. Greil7, B.C. Pestalozzi1, H. Stoeger8, A. Gerger8, A. Egle3, M. Pichler8
  • 1Medizinische Onkologie, Universitätsspital Zürich, 8091 - Zürich/CH
  • 2Department Of Internal Medicine, Medical University Graz, 8036 - Graz/AT
  • 3Division Of Oncology, Paracelsus University Hospital Salzburg, 2050 - Salzburg/AT
  • 4Iiird Medical Department With Hematology And Medical Oncology, Oncologic Center, Paracelsus University Hospital Salzburg, 5020 - Salzburg/AT
  • 5Klinik Für Viszeral- Und Transplantationschirurgie, University Hospital Zürich, Zürich/CH
  • 6Pathology, Paracelsus University Hospital Salzburg, Salzburg/AT
  • 7Head Of The Iiird Medical Department, Paracelsus University Hospital Salzburg, 5020 - Salzburg/AT
  • 8Clinical Division Of Medical Oncology, Department Of Internal Medicine, Medical University Graz, 8036 Graz - Graz/AT



Both fibrinogen and C-reactive protein (CRP) are biomarkers of systemic inflammation, but differ regarding their half-life, underlying pathophysiological triggers, genetic background and cellular as well as molecular effects. The aim of this study was to investigate the fibrinogen/CRP ratio (FCR) as a prognostic blood-based biomarker for survival outcome in patients with pancreatic cancer.


609 consecutive patients with pancreatic adenocarcinoma (Stage I-III: n = 253 (41.5%), Stage IV: n = 356 (58.5%) from a tri-center cohort study (Austria and Switzerland) had routine measurements of fibrinogen and CRP levels at the time of diagnosis, and were followed until the occurrence of death-from-any-cause. The FCR was defined as the ratio of fibrinogen (in mg/dL) to CRP (in mg/L).


During a median follow-up period of 3.8 years (range: 3 days-8.4 years), 511 (83.9%) patients died (1-, 3-, and 5-year overall survival (OS) probabilities (95%CI): 45.2% (41.1-49.2), 14.0% (11.2-17.2), and 7.4% (5.0-10.4), respectively. Patients with an elevated FCR, defined as an FCR > 75th percentile of the FCR distribution (cut-off: 145.3 units), had a significantly higher 1-year OS than patients ≤ this cut-off (60.2% vs. 40.2%, p 


In this large tri-center cohort of patients with pancreatic adenocarcinoma, we observed a strong association between a high FCR and a lower risk of death in patients with metastatic disease but not in patients with localized disease. An elevated FCR at baseline defines a novel clinical subset of patients with metastatic pancreatic cancer who have a remarkable survival advantage.

Clinical trial identification

Legal entity responsible for the study



University Graz, Salzburg, Zurich


All authors have declared no conflicts of interest.