# Prognostic value of fibrinogen change value in adrenocortical carcinoma patients

## TL;DR

This study shows that changes in fibrinogen levels before and after surgery can predict relapse-free survival in adrenocortical carcinoma patients.

## Contribution

The study identifies fibrinogen change value (FCV) as a potential new biomarker for predicting relapse-free survival in adrenocortical carcinoma.

## Key findings

- ACC patients had significantly higher preoperative fibrinogen levels compared to adrenal adenoma patients.
- Lower FCV in ACC patients was associated with poorer relapse-free survival but not overall survival.
- FCV remained a significant predictor of relapse-free survival in multivariate analysis.

## Abstract

The aim was to explore the preoperative and postoperative fibrinogen changes value (FCV) as a prognosis biomarker for in patients with adrenocortical carcinoma (ACC).

We identified 42 patients with ACC and 190 patients with adrenal adenoma (AA) who underwent surgery at our institution between 2015 and 2023. Preoperative fibrinogen, postoperative fibrinogen and follow-up information of the patients were recorded and analysed. The relationship between FCV and overall survival (OS)/ relapse-free survival (RFS) was evaluated.

The mean level of preoperative and postoperative fibrinogen for ACC were 4.00 ± 1.64 g/L and 2.75 ± 0.59 g/L, respectively (p < 0.001). The mean level of preoperative and postoperative fibrinogen for AA were 2.79 ± 0.59 g/L and 2.71 ± 0.58 g/L, respectively (p = 0.144). In ACC, the lower FCV (≤ 1.25 g/L) showed a significantly poorer RFS than the higher (> 1.25 g/L) (p = 0.007); however, the lower FCV (≤ 1.25 g/L) showed no poorer OS than the higher (> 1.25 g/L) (p = 0.243). On multivariate survival analyses, FCV remained a predictor of RFS (HR 3.138).

According to the data in this study, it can be said that FCV is correlated with prognosis of ACC. The FCV might be a new biomarker for predicting the RFS of ACC.