Clinical significance of plasma D-dimer and fibrinogen in digestive cancer: A systematic review and meta-analysis

Lin, Yan; Liu, Zhihui; Qiu, Yufen; Zhang, Jinyan; Wu, Haoran; Liang, Rong; Chen, Guoying; Qin, Gang; Li, Yongqiang; Zou, Donghua

doi:10.1016/j.ejso.2018.07.052

Cited by 110 publications

(86 citation statements)

References 59 publications

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“…[25] Fibrinogen concentration before treatment is a known prognostic factor not only in primary and metastatic colorectal cancer but also in other gastrointestinal cancers in terms of overall and disease-free survival. [26,27] Additionally, the concentration of brinogen, which is also an acute phase reactant, is increased during the intense in ammatory response. It was also shown that presurgical systemic in ammatory response increases the risk of infectious postoperative complications, which also include AL.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the risk of permanent stoma after low anterior resection in rectal cancer patients

Zeman

Czarnecki

Chmielarz

et al. 2020

Preprint

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Background: One of the most severe complications of low anterior rectal resection is anastomotic leakage (AL). The creation of a loop ileostomy (LI) reduces the prevalence of AL requiring surgical intervention. However, up to one-third of temporary stomas may never be closed.The first aim of the study was to perform a retrospective assessment of the impact of LI on the risk of permanent stoma (PS) and symptomatic AL. The second aim of the study was to assess preoperative PS risk factors in patients with LI.Methods: A total of 286 consecutive patients who underwent low anterior rectal resection were subjected to retrospective analysis. In 101 (35.3%) patients, diverting LI was performed due to low anastomosis, while in the remaining 185 (64.7%) patients, no ileostomy was performed. LIs were reversed after adjuvant treatment. Analyses of the effect of LI on symptomatic AL and PS were performed. Among the potential risk factors for PS, clinical factors and the values of selected peripheral blood parameters were analysed.Results: PS occurred in 37.6% and 21.1% of the patients with LI and without LI, respectively (p <0.01). Symptomatic ALs were significantly more common in patients without LI. In this group, symptomatic ALs occurred in 23.8% of patients, while in the LI group, they occurred in 5% of patients (p <0.001). In the LI group, the only significant risk factor for PS in the multivariate analysis was preoperative plasma fibrinogen concentration (OR = 1.007, 97.5% CI 1.002-1.013, p = 0.013).Conclusions: Although protective LI may reduce the incidence of symptomatic AL, it can be related to a higher risk of PS in this group of patients. The preoperative plasma fibrinogen concentration can be a risk factor for PS in LI patients and may be a useful variable in decision-making models.

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Section: Discussionmentioning

confidence: 99%

Assessment of the risk of permanent stoma after low anterior resection in rectal cancer patients

Zeman

Czarnecki

Chmielarz

et al. 2020

Preprint

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“…It is generally regarded as a key factor of coagulation and brinolytic activation. Recently, A lot of research shows that an elevated pre-treatment plasma Fib level is closely associated with poor prognosis in patients with various malignant tumours [18][19][20][21], including breast cancer [12][13][14]. In a large retrospective study of 2073 consecutive breast cancer patients, Wen et al [12] reported that an elevated preoperative plasma Fib level was an independent prognostic factor for overall survival in breast cancer patients who underwent surgical treatment (p=0.001).…”

Section: Discussionmentioning

confidence: 99%

Plasma Fibrinogen Acts as a Predictive Factor for Pathologic Complete Response to Neoadjuvant Chemotherapy in Breast Cancer: A Retrospective Study of 1035 Chinese Breast Cancer Patients

Wang

Chen

et al. 2020

Preprint

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Background: The aim of this study was to evaluate the relationship between pre-treatment plasma fibrinogen (Fib) level and pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer patients and to assess the role of plasma Fib as a predictive factor.Methods: Data from 1035 consecutive patients with invasive breast cancer who received NAC and subsequent surgery were retrospectively analysed. Both univariate and multivariate analyses were performed to identify clinicopathological factors associated with pCR to NAC.Results: The median value of Fib, rather than other plasma coagulation parameters, was significantly increased in non-pCR patients compared with pCR patients (P = 0.008). Based on the cut-off value estimated by the ROC curve analysis, samples were divided into low or high Fib groups (Fib < 3.145 g/L or ≥ 3.145 g/L). Low Fib status was significantly associated with premenopausal or perimenopausal status (P < 0.001), ≤ 5cm tumour size (P = 0.001), positive hormone receptor status (P = 0.003) and > 14% Ki67 index (P = 0.028). Adjusted for other clinicopathologic factors in the multivariate logistic regression model, low Fib status was strongly associated with pCR to NAC (OR = 2.365, 95% CI = 1.354-4.133, P = 0.002).Conclusions: This study demonstrates that low pre-treatment plasma Fib (Fib < 3.145 g/L) is an independent predictive factor for pCR to NAC in breast cancer patients.

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“…We found that preoperative D-dimer and albumin levels in OCCC patients were signi cantly correlated with platinum resistance and were independent predictors of PFS and OS. Patients with cancer often exhibit a state of hypercoagulation and exaggerated brinolysis [22] . D-dimer, as an end product of brinogen, is a signal of the activated coagulation system in numerous cancer types especially in the advanced stage [23,24] .…”

Section: Discussionmentioning

confidence: 99%

Serum D-dimer, Albumin and Systemic Inflammatory Response Markers in Ovarian Clear Cell Carcinoma and Their Prognostic Implications

Chen

Zhong

Shan

et al. 2020

Preprint

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Background: This study attempts to evaluate whether preoperative systemic inflammatory response (SIR) markers or other hematological variables, such as albumin, D-dimer, and carbohydrate antigen 125, play roles in predicting chemotherapy response and survival outcome in patients with ovarian clear cell carcinoma (OCCC).Methods: Preoperative leukocyte differential counts, as well as platelet, serum albumin, plasma D-dimer and CA-125 levels, were measured in patients with FIGO IC-IV ovarian clear cell cancer. The correlations of these hematological biomarkers with clinicopathological features, chemotherapy response, and survival outcomes were further analyzed. Survival time was estimated using the Kaplan-Meier model, whereas Cox regression was conducted for multivariate analysis.Results: Among the 84 patients, 28.6% were classified as platinum resistant, and 69.0% were platinum sensitive. Preoperative CA125, albumin, and D-dimer levels; neutrophil to lymphocyte ratios (NLR); and monocyte to lymphocyte ratios were significantly correlated with FIGO stage, residual tumor, and platinum response. Platelet to lymphocyte ratio was not related to platinum response (P=0.060). The median follow-up time was 28 months (range, 1 to 128 months). Preoperative CA125, albumin, and D-dimer levels were significant prognostic factors for overall survival (OS) and progression-free survival (PFS). In the univariate analysis, only NLR exhibited prognostic significance for PFS (P = 0.007). Multivariate analysis indicated that D-dimer > 3.27 (P = 0.001 for OS; P = 0.040 for PFS) and albumin <39.6 (P = 0.005 for OS and P = 0.041 for PFS) retained significance.Conclusions: Preoperative NLR has some predictive value for platinum resistance in patients with IC-IV stage OCCC but has little predictive effect on prognosis. Elevated D-dimer and reduced albumin might be potential biomarkers for worse response to first-line platinum-based chemotherapy and poor clinical outcomes.

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Clinical significance of plasma D-dimer and fibrinogen in digestive cancer: A systematic review and meta-analysis

Abstract: Both of pretreatment plasma D-dimer and fibrinogen were robust predictors of poor survival in digestive cancer patients with different traits. Further studies are warranted to verify their roles on cancer prognosis.

Cited by 110 publications

References 59 publications

Assessment of the risk of permanent stoma after low anterior resection in rectal cancer patients

Assessment of the risk of permanent stoma after low anterior resection in rectal cancer patients

Plasma Fibrinogen Acts as a Predictive Factor for Pathologic Complete Response to Neoadjuvant Chemotherapy in Breast Cancer: A Retrospective Study of 1035 Chinese Breast Cancer Patients

Serum D-dimer, Albumin and Systemic Inflammatory Response Markers in Ovarian Clear Cell Carcinoma and Their Prognostic Implications

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