Fibrinogen/albumin ratio as a promising predictor of platinum response and survival in ovarian clear cell carcinoma

This study aims to evaluate the role of the fibrinogen/albumin ratio (FAR) in predicting platinum resistance and survival outcomes of patients with ovarian clear cell carcinoma (OCCC). Methods: Coagulation function and D-dimer, serum albumin, CA125 and HE4 levels were measured before surgery in OCCC patients undergoing initial surgery in our institution.
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Fibrinogen/albumin ratio as a promising predictor of platinum response and survival in ovarian clear cell carcinoma Chen et al. BMC Cancer (2022) 22:92 https://doi.org/10.1186/s12885-022-09204-0 RESEARCH Open Access Fibrinogen/albumin ratio as a promising predictor of platinum response and survival in ovarian clear cell carcinoma Wei Chen1,2†, Boer Shan1,3†, Shuling Zhou3,4, Huijuan Yang1,3* and Shuang Ye1,3*  Abstract  Background:  This study aims to evaluate the role of the fibrinogen/albumin ratio (FAR) in predicting platinum resist- ance and survival outcomes of patients with ovarian clear cell carcinoma (OCCC). Methods:  Coagulation function and D-dimer, serum albumin, CA125 and HE4 levels were measured before surgery in OCCC patients undergoing initial surgery in our institution. FAR was calculated as fibrinogen/albumin level. The correlation between these indicators and clinicopathological features, platinum response, and survival outcomes was further analyzed. The Kaplan-Meier method and multivariable Cox regression model were used to assess the effects of FAR on progression-free survival (PFS) and overall survival (OS). Results:  Advanced stage patients accounted for 42.1% of the 114 participants. Optimal cytoreductive surgery was achieved in 105 patients, and the complete resection rate was 78.1%. FAR was associated with tumor stage, residual tumor and platinum response. A receiver operating characteristic curve for predicting platinum response showed that the optimal cutoff point of the FAR was 12%. The sensitivity was 73.3% and the specificity was 68.2%. In multivariate analysis, FAR ≥12% (HR = 4.963, P = 0.002) was an independent risk factor for platinum resistance. In addition, FAR and D-dimer proved to be independent negative factors for outcomes including both PFS and OS. The median follow-up time was 52 months. A high FAR (≥ 12%) showed a stronger correlation with poor OS and PFS in the subgroup analy- sis of advanced and completely resected patients. Conclusions:  The FAR might be a potential preoperative biochemical marker for predicting treatment response and oncological outcomes in OCCC patients. Keywords:  Ovarian neoplasms, Clear cell carcinoma, Fibrinogen/albumin ratio, Platinum resistance, Survival Background women [2]. Tumor stage, residual tumor and chemo- Ovarian cancer is one of the most lethal diseases among therapy response are recognized as prognostic factors for gynecological malignancies [1]. Seventy percent of ovar- survival in ovarian cancer [3]. Although many patients ian cancers are epithelial, of which ovarian clear cell with OCCC are diagnosed at an early stage, their progno- carcinoma (OCCC) is a specific type of epithelial ovar- sis is still worse due to disease aggressiveness and plati- ian cancer (EOC) with a higher incidence in East Asian num resistance compared to their serous counterparts, which account for the highest proportion [4, 5]. In addi- tion, OCCC patients who harbor the same stage or resid- *Correspondence: huijuanyang@hotmail.com; mendy_ye@126.com † Wei Chen and Boer Shan contributed equally to this work. ual tumors also show obvious heterogeneous survival due 3 Department of Oncology, Shanghai Medical College, Fudan University, to their unpredictable response to platinum [6]. The high Shanghai 200032, China cost of genetic markers limits their application in clinical Full list of author information is available at the end of the article © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit ...