Objective  This paper aimed to determine the association of pre-operative plasma fibrinogen levels with the clinicopathological parameters and overall survival in patients with renal cell carcinoma.

  Methods  We retrospectively studied 286 patients with renal cell carcinoma who underwent radical nephrectomy from January 2000 to December 2003 in one facility.The plasma fibrinogen level was routinely determined before surgery in all patients.The pre-operative plasma fibrinogen levels were correlated with clinicopathological findings by the t-test or ANOVA methods.Univariate and multivariate analyses were used to determine the association of pre-operative levels of plasma fibrinogen with survival duration.

  Results  Elevated plasma fibrinogen level was positively correlated with the Fuhrman grade(P < 0.001), tumor size(P < 0.001), T stage(P < 0.001), and risk of distant metastasis after operation(P < 0.001). However, the elevated plasma fibrinogen level was negatively correlated with the histologic type(P=0.266).Univariate analysis showed that the Fuhrman grade, tumor size, T stage, and plasma fibrinogen level were significantly correlated with overall survival(P < 0.001.P=0.001, P < 0.001, and P < 0.001).Multivariate analysis showed that the plasma fibrinogen level remained as an independent prognostic factor for overall survival(P=0.001).

  Conclusion  The pre-operative plasma fibrinogen level is significantly associated with postoperative distant metastasis and overall survival, and is an independent predictor of survival prognosis after radical nephrectomy for patients with renal cell carcinoma.