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The D-dimer level predicts the postoperative prognosis in patients with non-small cell lung cancer.

ABSTRACT: BACKGROUND:Carcinoma cells often modulate coagulation and fibrinolysis among cancer patients. Plasma dimerized plasmin fragment D (D-dimer) has been reported as a prognostic marker of various types of malignancies, including non-small cell lung cancer (NSCLC). However, the associations between the plasma D-dimer level and peripheral small NSCLC remain unclear. METHODS:Three hundred and sixty-two patients with NSCLC who underwent radical surgery were retrospectively reviewed. Patients who received anticoagulation therapy before surgery or who lacked preoperative D-dimer data were excluded. The other 235 patients were divided into a high D-dimer (over 1.0 ?g/mL) group (HDD group, n = 47) and a normal D-dimer group (NDD group, n = 188) and investigated for their clinical characteristics, computed tomography (CT) findings, pathological findings, and clinical outcomes. RESULTS:The mean D-dimer levels was 2.49±2.58 ?g/ml in the HDD group and 0.42±0.23 ?g/ml in the NDD group. The HDD group was characterized by a predominance of male gender, older age, pure solid appearance on chest CT, vascular invasion in pathology, and a large solid part of the tumor. The HDD group showed a worse overall survival, disease-free survival, and disease-specific survival than the NDD group (p<0.001, <0.001, <0.001, respectively). These survival features were also observed in p-Stage IA disease. There was no marked survival difference when tumors showed ground-glass opacity on CT. CONCLUSION:In NSCLC patients with a solid tumor appearance on CT, high D-dimer levels predict a poor survival and early recurrence.

SUBMITTER: Shiina Y

PROVIDER: S-EPMC6932866 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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The D-dimer level predicts the postoperative prognosis in patients with non-small cell lung cancer.

Shiina Yuki Y Nakajima Takahiro T Yamamoto Takayoshi T Tanaka Kazuhisa K Sakairi Yuichi Y Wada Hironobu H Suzuki Hidemi H Yoshino Ichiro I

PloS one 20191226 12

<h4>Background</h4>Carcinoma cells often modulate coagulation and fibrinolysis among cancer patients. Plasma dimerized plasmin fragment D (D-dimer) has been reported as a prognostic marker of various types of malignancies, including non-small cell lung cancer (NSCLC). However, the associations between the plasma D-dimer level and peripheral small NSCLC remain unclear.<h4>Methods</h4>Three hundred and sixty-two patients with NSCLC who underwent radical surgery were retrospectively reviewed. Patie ...[more]

PMID: 31877562

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Project description:BackgroundVenous thromboembolism (VTE) occurs at a high rate after lung cancer surgery and can be attributed to various clinical risk factors. Here, we aimed to determine whether early detection of perioperative D-dimer and risk-stratified cutoff values would improve the diagnostic efficacy of VTE.MethodsIn this case-control study, D-dimer results were acquired from 171 non-small cell lung cancer (NSCLC) patients preoperatively and at the first, third, and fifth day after surgery. VTE was confirmed by Doppler ultrasonography and computer tomography pulmonary angiography (CTPA). Repeated measures ANOVA was used to analyze how D-dimer changed with time and the effects of risk factors on D-dimer levels. We then compared sensitivity, specificity and negative predictive value, using both adjusted and unadjusted cutoff values.ResultsVTE occurred in 23 patients (13.5%) of the study population. D-dimer levels increased unsustainably after lung cancer surgery (P < 0.001) due to a trough on the third day, and patients who had undergone thoracotomy (P < 0.001) and those at a more advanced tumor stage (P = 0.037) had higher D-dimer levels. Area under the curve of D-dimer was greatest on the third day (0.762 [P < 0.001, 95% CI: 0.643-0.882]). Applying stratified cutoff values improved the specificity in the video-assisted thoracoscopy surgery (VATS) (P = 0.004) and thoracotomy groups (P < 0.001).ConclusionsD-dimer levels elevated with fluctuation in NSCLC patients after surgery. Surgical options and tumor stages had an impact on D-dimer levels. With regard to VTE diagnosis, stratified cutoff values by these two factors showed better accuracy compared with a collective one..Key pointsSIGNIFICANT FINDINGS OF THE STUDY: The changing pattern of perioperative D-dimer levels in NSCLC patients who received surgical therapy in a major teaching hospital in Beijing, China was revealed.What this study addsRisk-stratified D-dimer cutoff values adjusted to surgical methods and disease stages would benefit the exclusion of postoperative venous thromboembolism.

Dataset Information

The D-dimer level predicts the postoperative prognosis in patients with non-small cell lung cancer.

Publications

The D-dimer level predicts the postoperative prognosis in patients with non-small cell lung cancer.

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