Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May 25:13:4191-4201.
doi: 10.2147/CMAR.S311347. eCollection 2021.

A Nomogram Model Involving Preoperative Fibrinogen and Prognostic Nutritional Index Score for Predicting Postoperative Outcome in Patients with Gastric Cancer

Panxing Wang  1 , Haijiang Wang  1 , Guanglin Qiu  1 , Jiahuang Liu  1 , Lin Fan  1 , Xinhua Liao  1 , Xiangming Che  1
Affiliations

A Nomogram Model Involving Preoperative Fibrinogen and Prognostic Nutritional Index Score for Predicting Postoperative Outcome in Patients with Gastric Cancer

Panxing Wang et al. Cancer Manag Res. .

Abstract

Background: Inflammation and nutrition play vital roles in the development of gastric cancer (GC). We combined the preoperative fibrinogen with prognostic nutritional index (PNI) to create a novel scoring system named as the fibrinogen and prognostic nutritional index (FPNI) score and establish a more effective model.

Patients and methods: A total of 689 patients with gastric adenocarcinoma who underwent gastrectomy from January 2012 to December 2016 were reviewed. We measured correlations between FPNI score and clinicopathological variables and overall survival (OS). A nomogram predicting OS was constructed. Its predictive performance was verified using the concordance index, calibration curves, receiver operating characteristic curves, decision curve analysis and time-dependent receiver operating characteristic analysis.

Results: We observed that the FPNI score was an independent predictor of OS in patients with gastric cancer (P < 0.05). A high FPNI score was significantly related to older age at surgery, tumor size ≥4.6 cm, high ASA score, advanced TNM stage and poor outcome (both P < 0.05). And the FPNI score remained an independent indicator at various TNM stages (P < 0.05). Ultimately, the nomogram based on FPNI score, age, tumor size, histological grade and TNM stage showed a better predictive ability than TNM alone.

Conclusion: The preoperative FPNI score is a novel, simple, and effective predictor of OS in patients with GC. Furthermore, the nomogram involving FPNI score will help clinicians to optimize individualized treatment plans.

Keywords: fibrinogen; gastric cancer; nomogram; overall survival; prognostic nutritional index.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1
Kaplan–Meier analysis for OS of GC patients according to preoperative plasma fibrinogen level and prognostic nutritional index (PNI). Kaplan–Meier analysis for OS according to (A) preoperative plasma fibrinogen level, (B) preoperative PNI, (C) combination of preoperative plasma fibrinogen and PNI, and (D) FPNI score.
Figure 2
Figure 2
Nomogram for predicting 3- and 5-year OS of GC patients after surgery.
Figure 3
Figure 3
External validation of the nomogram: Calibration plot of the nomogram describing 3- (A) and 5-year (B) OS.
Figure 4
Figure 4
Decision curve analysis (DCA) curves comparing nomogram and TNM stage. The y-axis represented net benefits and the x-axis measured threshold probability (Pt).
Figure 5
Figure 5
Time-dependent ROC curves for the nomogram and TNM stage. The horizontal axis represents year after surgery, and the vertical axis represents the estimated AUC for survival at the time of interest. Yellow solid lines represent the estimated AUCs for the nomogram, and broken lines represent the 95% confidence intervals for AUC. Blue solid lines represent the estimated AUCs for TNM stage, and broken lines represent the 95% confidence intervals for AUC.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Sung H, Ferlay J, Siegel R, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021. doi:10.3322/caac.21660 - DOI - PubMed
    1. Yamaguchi T, Yamamoto Y, Yokota S, et al. Involvement of interleukin-6 in the elevation of plasma fibrinogen levels in lung cancer patients. Jpn J Clin Oncol. 1998;28(12):740–744. doi:10.1093/jjco/28.12.740 - DOI - PubMed
    1. Tennent GA, Brennan SO, Stangou AJ, et al. Human plasma fibrinogen is synthesized in the liver. Blood. 2007;109(5):1971–1974. doi:10.1182/blood-2006-08-040956 - DOI - PubMed
    1. Suzuki T, Shimada H, Nanami T, et al. Hyperfibrinogenemia is associated with inflammatory mediators and poor prognosis in patients with gastric cancer. Surg Today. 2016;46(12):1394–1401. doi:10.1007/s00595-016-1339-z - DOI - PubMed
    1. Wu Z, Xu H, Wang R, et al. Cumulative score based on preoperative fibrinogen and pre-albumin could predict long-term survival for patients with resectable gastric cancer. J Cancer. 2019;10(25):6244–6251. doi:10.7150/jca.35157 - DOI - PMC - PubMed