ONCOLOGY / RESEARCH PAPER

The influences of selected clotting and fibrinolysis factors on survival of patients with kidney tumors – a prospective study
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1 |
Subdivision of Urology, Wroclaw Comprehensive Cancer Centre, Wroclaw, Poland |
2 |
Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University,
Wroclaw, Poland |
3 |
Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders,
Wroclaw Medical University, Wroclaw, Poland |
4 |
Department of Pathomorphology and Oncological Cytology, Wroclaw Medical University,
Wroclaw, Poland |
5 |
Department of Pathomorphology, Wroclaw Comprehensive Cancer Centre, Wroclaw, Poland |
6 |
Department of Urology and Oncological Urology, Wroclaw Medical University,
Wroclaw, Poland |
CORRESPONDING AUTHOR
Krzysztof Tupikowski
Wroclaw Comprehensive Cancer Centre, pl. Hirszfelda 12, 53-413, Wroclaw, Poland
Submission date: 2020-06-04
Final revision date: 2020-10-10
Acceptance date: 2020-10-25
Online publication date: 2021-04-08
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Multiple studies suggest that cancer leads to activation
of clotting and fibrinolysis pathways, elevating the risk of thromboembolic
events. Kidney cancer is often complicated by clotting disorders. In this
study, we hypothesized that preoperative clotting and fibrinolysis parameters are altered in healthy volunteers and kidney tumor patients. We also
hypothesized that these differences may be associated with survival in patients who have undergone operations due to kidney tumors.
Material and methods:
In this study, 96 patients with kidney tumors and 30
healthy volunteers were recruited at a single university center. All patients
were assessed for pre-operative serum concentrations of tissue factor (TF), tissue factor pathway inhibitor (TFPI, total TFPI, full-length TFPI, truncated TFPI),
plasmin-antiplasmin complex (PAP), thrombin-antithrombin complex (TAT), von
Willebrand factor (vWF), clotting factor XIII A1 (FXIIIA1), D-dimers, and fibrinogen. Additionally, standard peripheral blood morphology was evaluated.
Results:
Malignant kidney tumors were diagnosed in 85 of 96 tumor patients. In patients with kidney tumors, there were statistically significantly
higher concentrations of fibrinogen, D-dimers, TAT, PAF, TF, TFPI, vWF, FXIIIA1,
and leukocyte counts compared to the control group. Statistically significant
correlations were found between multiple parameters. This points to significant clotting system alterations. Cox stepwise hazard analysis showed
that pre-operative fibrinogen and D-Dimer concentrations were significantly
associated with survival.
Conclusions:
In patients with kidney tumors, multiple clotting and fibrinolysis parameters are significantly altered. Routine pre-operative measures
should include determination of fibrinogen and D-dimer concentrations as
these markers aid in prediction of survival probability.