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Prognostic Value of Cumulative Score Based on Preoperative Fibrinogen and Albumin Level in Skull Base Chordoma

Authors Li M, Bai J, Wang S, Zhai Y, Zhang S, Li C, Du J, Zhang Y

Received 10 April 2020

Accepted for publication 30 July 2020

Published 20 August 2020 Volume 2020:13 Pages 8337—8346


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Tohru Yamada

Mingxuan Li,1 Jiwei Bai,2 Shuai Wang,1 Yixuan Zhai,3 Shuheng Zhang,1 Chuzhong Li,1 Jiang Du,4 Yazhuo Zhang1,2,5– 7

1Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China; 2Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 4Department of Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China; 5Beijing Institute for Brain Disorders Brain Tumor Center, Beijing, People’s Republic of China; 6China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China; 7Key Laboratory of Central Nervous System Injury Research, Capital Medical University, Beijing, People’s Republic of China

Correspondence: Yazhuo Zhang Email

Objective: Inflammation and malnutrition have been shown to be correlated with tumor progression and a poor prognosis in various cancers. However, the clinical implications of biomarkers of inflammation and malnutrition in chordoma have not been elucidated. We attempted to characterize the fibrinogen and albumin levels in skull base chordoma and investigate their correlations with clinicopathological data and survival.
Methods: The preoperative levels of fibrinogen and albumin were assessed in 183 primary skull base chordoma patients. The cutoff values were determined by X-tile software, and their correlations with patient prognosis were further explored using the Kaplan–Meier curve and Cox proportional hazards regression analysis. In addition, the predictive performances of these markers in survival were evaluated by receiver operating characteristic curves.
Results: The values of fibrinogen and albumin in skull base chordoma patients ranged from 1.73 to 7.40 and 37.6 to 53.0 g/L, respectively. The optimal cutoff values for fibrinogen and albumin were 3.29 and 44.60 g/L, respectively. Fibrinogen and albumin were correlated with the patient age and tumor pathology types. Albumin, but not fibrinogen, was associated with the patients’ progression-free survival and overall survival. Importantly, the FA score, which combines fibrinogen and albumin, could independently predict both progression-free survival and overall survival, and enhanced the performance of fibrinogen or albumin in survival prediction in skull base chordoma.
Conclusion: Our data reveal the clinical prognostic role of albumin and suggest that the FA score may be a valuable prognostic grading system in skull base chordoma.

Keywords: skull base chordoma, fibrinogen, albumin, biomarker, prognosis

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