Baseline Serum C-Reactive Protein and Plasma Fibrinogen-Based Score in the Prediction of Survival in Glioblastoma

The present study investigates a score based on baseline C-reactive protein (CRP) and fibrinogen values (FC score) in 173 consecutive glioblastoma (GBM) patients. The optimal cut-off value for fibrinogen and CRP was defined as 3.5 g/dl and 3.0 mg/L, respectively, according to previous reports. Patients with elevated CRP and fibrinogen were classified with a score of 2, those with an elevation of only one of these parameters were allocated a score of 1, and those without any abnormalities were assigned a score of 0. No significant differences in age, gender, tumor area, molecular pathology, physical status, or extent of resection were identified among the three groups defined by this score. Univariate survival analysis demonstrated that a high baseline FC score (≥1) is significantly associated with a shortened overall survival (OS) (HR: 1.52, 95% CI: 1.05-2.20, = 0.027). A multivariate Cox regression analysis considering age (>65/≤65), extent of resection (GTR/STR), MGMT promoter status (hypermethylated/non-hypermethylated), and FC score (0/≥1) confirmed that an elevated FC score (≥1) is an independent predictor of shortened OS (HR: 1.71, 95% CI: 1.16-2.51, = 0.006). The baseline fibrinogen and CRP score thus serves as an independent predictor of OS in GBM. Further investigations of the role of inflammation in the prediction of a prognosis are needed.