Prognostic value of preoperative coagulation scoring system in patients with oral squamous cell carcinoma.

Abstract

Abnormal coagulation function is closely associated with the prognosis of patients with malignant tumors. In this study, we aimed to explore the prognostic value of preoperative coagulation scoring system in patients with oral squamous cell carcinoma (OSCC). A total of 267 patients with OSCC who were treated at the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University between January 2016 and December 2019 were included. Survival prediction values for fibrinogen level and international normalized ratio (INR) were identified according to receiver operating characteristic (ROC) cut-off analysis. Patients were divided into three groups based on the F-INR score combined with fibrinogen and INR: score 2 group (both high fibrinogen and high INR), score 1 group (either elevated fibrinogen or INR), and score 0 group (neither abnormality). The association between F-INR score and clinicopathological parameters was evaluated. The clinical risk factors were evaluated using univariate and multivariate Cox regression analyses. Kaplan-Meier analysis was used to estimate the survival of patients with OSCC. The predictive value of preoperative F-INR in OSCC was better than that of fibrinogen and INR alone (area under the curve, (AUC): 0.766 vs. 0.704 vs. 0.611). Multivariate Cox regression analysis showed that F-INR may be an independent predictor of cancer-specific survival (CSS) in OSCC (F-INR 1, hazard ratio [HR] = 8.210, 95%CI: 1.156-58.282, p = 0.035; F-INR 2, HR = 2.475, 95%CI: 1.284-4.772, p = 0.007). Kaplan-Meier analysis indicated that patients with high fibrinogen levels or F-INR had a poor prognosis (p < 0.05). Preoperative F-INR may be an independent prognostic factor in patients with OSCC.