The Clinical significance of Coagulation Factors in Operable Colorectal Cancer Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea

Objective: Abnormal hemostasis in cancer patients has previously been studied. The principal objective of this study is to determine whether preoperative coagulation factors are related with the clinicopathologic characteristics and to clarify which coagulation factors have prognostic significance in operable colorectal cancer patients. Patients and Methods: This study evaluated 170 patients who underwent curative surgery for colorectal carcinoma. Preoperative coagulation tests included platelet, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, D-dimer, fibrinogen degradation product (FDP). The clinicopathological variables including age, gender, tumor location (rectum/colon), preoperative carcinoembryonic antigen (CEA), tumor size (≥5cm vs. <5cm), depth of tumor invasion, lymph node metastasis, stage, lymphovascular invasion, and histologic differentiation were analyzed. Progression-free survival and overall survival were analyzed by Kaplan-Meier analysis. Results: The median age of analyzed patients was 63 years (range; 28~84). Male to female ratio was 62:38. The median follow-up duration was 21.05 months (range; 0.30-56.30). Higher plasma fibrinogen, PT and PLT levels were associated with larger tumor size (p<0.001, p=0.005, and p=0.004, respectively). Higher plasma fibrinogen level was significantly associated with depth of tumor invasion and stage (p=0.014 and p=0.036, respectively). Median progression-free survival was 10.2 month. Overall survival was not reached on median value. However, serum plasma fibrinogen showed no significant factor in predicting progression-free survival and overall survival. Conclusion: Preoperative plasma fibrinogen level is significantly associated with tumor size and depth of tumor invasion. Thus, plasma fibrinogen level might suggest increased early tumor burden. However, plasma fibrinogen did not show a prognostic value.