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Ehrnrooths Stiftelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>\n                    <jats:styled-content style=\"fixed-case\">ABSTRACT<\/jats:styled-content>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pancreatic ductal adenocarcinoma (PDAC) is highly thrombogenic and lethal, with rising incidence. Combining carbohydrate antigen (CA) 19\u20139, fibrinogen, coagulation factor VIII (FVIII), albumin, and alkaline phosphatase (ALP) as a diagnostic panel improves diagnostics. We evaluated the prognostic value of this panel in neoadjuvant therapy (NAT) and upfront surgery (US) treated patients undergoing radical\u2010intent surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      PDAC patients undergoing radical\u2010intent surgery with available preoperative coagulation variables were included (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009205). Patients with borderline resectable tumors received NAT (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200976). The diagnostic panel and a modified panel including only fibrinogen, FVIII, and CA 19\u20139 were assessed preoperatively and evaluated for disease\u2010specific and disease\u2010free survival (DSS and DFS, respectively). Follow\u2010up was for at least two years or until earlier death.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Preoperative fibrinogen was higher in the US\u2010treated PDAC patients (US PDAC) than in the NAT\u2010treated PDAC patients (NAT PDAC) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Elevated fibrinogen, FVIII, and CA 19\u20139 predicted poor DSS individually and as a panel among NAT PDAC; a low modified panel score was associated with better DSS than higher panel scores (HR 7.8, 95% CI 1.7\u201336.1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preoperatively elevated fibrinogen and FVIII indicated a worse prognosis among NAT patients, especially when combined with CA 19\u20139 in a panel, possibly referring to treatment response after NAT. Further studies should assess whether preoperative dampening of coagulation activity would improve survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71954","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:07:07Z","timestamp":1779358027000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative Biomarker Panel With Fibrinogen, FVIII, and CA 19\u20139 as a Tool for Prognostic Evaluation in Neoadjuvant\u2010Treated Pancreatic Ductal Adenocarcinoma"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4007-6555","authenticated-orcid":false,"given":"Nora","family":"Mattila","sequence":"first","affiliation":[{"name":"Department of Surgery University of Helsinki (UH) and Helsinki University Hospital (HUH)  Helsinki Finland"},{"name":"Department of Hematology, Coagulation Disorders Unit, Comprehensive Cancer Center, Research Program in Systems Oncology UH and HUH  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riitta","family":"Lassila","sequence":"additional","affiliation":[{"name":"Department of Hematology, Coagulation Disorders Unit, Comprehensive Cancer Center, Research Program in Systems Oncology UH and HUH  Helsinki Finland"},{"name":"Translational Cancer Medicine Program UH and HUH  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harri","family":"Mustonen","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Helsinki (UH) and Helsinki University Hospital (HUH)  Helsinki Finland"},{"name":"Translational Cancer Medicine Program UH and HUH  Helsinki Finland"},{"name":"ICAN Digital Precision Cancer Medicine Flagship UH  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caj","family":"Haglund","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Helsinki (UH) and Helsinki University Hospital (HUH)  Helsinki Finland"},{"name":"Translational Cancer Medicine Program UH and HUH  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Sepp\u00e4nen","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Helsinki (UH) and Helsinki University Hospital (HUH)  Helsinki Finland"},{"name":"Translational Cancer Medicine Program UH and HUH  Helsinki Finland"},{"name":"ICAN Digital Precision Cancer Medicine Flagship UH  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21590"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-023-14751-2"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.25288"},{"issue":"7","key":"e_1_2_11_6_1","article-title":"Diagnostic Accuracy of Laparoscopy Following Computed Tomography (CT) Scanning for Assessing the Resectability With Curative Intent in Pancreatic and Periampullary Cancer","volume":"7","author":"Allen V. 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