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Poster Display

4172 - An elevated fibrinogen/CRP ratio predicts a remarkable survival advantage in patients with metastatic pancreatic cancer

Date

08 Oct 2016

Session

Poster Display

Presenters

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

Author affiliations

  • 1 Medizinische Onkologie, Universitätsspital Zürich, 8091 - Zürich/CH
  • 2 Department Of Internal Medicine, Medical University Graz, 8036 - Graz/AT
  • 3 Division Of Oncology, Paracelsus University Hospital Salzburg, 2050 - Salzburg/AT
  • 4 Iiird Medical Department With Hematology And Medical Oncology, Oncologic Center, Paracelsus University Hospital Salzburg, 5020 - Salzburg/AT
  • 5 Klinik Für Viszeral- Und Transplantationschirurgie, University Hospital Zürich, Zürich/CH
  • 6 Pathology, Paracelsus University Hospital Salzburg, Salzburg/AT
  • 7 Head Of The Iiird Medical Department, Paracelsus University Hospital Salzburg, 5020 - Salzburg/AT
  • 8 Clinical Division Of Medical Oncology, Department Of Internal Medicine, Medical University Graz, 8036 Graz - Graz/AT
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Resources

Abstract 4172

Background

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.

Methods

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).

Results

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 

Conclusions

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

N/A

Funding

University Graz, Salzburg, Zurich

Disclosure

All authors have declared no conflicts of interest.

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