D-dimer, a predictor of bad outcome in gastric cancer patients undergoing radical resection

Abstract

As a marker of hypercoagulability, plasma D-dimer is associated with progression of many cancers but remains controversial in gastric cancer (GC). We aim to investigate the predictive value of D-dimer for postoperative outcomes after radical gastrectomy of GC patients. We enrolled 903 consecutive patients with GC who underwent radical gastrectomy and the clinicopathological characteristics were compared. Risk factors for overall survival (OS) and disease-free survival (DFS) were determined using multivariate cox regression analysis. We also compared the survival difference based on Kaplan–Meier method after a one-to-one propensity score matching (PSM). Patients with elevated D-dimer had older age (p < 0.001), advanced TNM stage (p < 0.001), larger tumor size (p = 0.005), lower 5-year OS rate (32.8% vs 62.6%, p < 0.001) and DFS (29% vs 59.6%, p < 0.001). In multivariate analysis, elevated D-dimer was independently associated with shorter OS [hazard ratio (HR): 1.633, 95% confidence interval (CI) 1.178–2.264, p = 0.003] and DFS (HR: 1.58, 95% CI 1.151–2.169, P = 0.005). After PSM, the 5-year OS rate of patients with elevated D-dimer was still significantly lower than matched group (32.8% vs 40.6%, p = 0.005), so was DFS (29% vs 36.6%, p = 0.008). Preoperative elevated D-dimer is an independent risk factor for GC patients undergoing curative gastrectomy.

Albumin-to-D-dimer ratios: A novel prognostic factor for evaluating first-line chemotherapy efficacy in advanced lung adenocarcinoma patients

“…Albumin, a potent hepatically synthesized protein, has gained widespread recognition as a serum inflammatory and nutritional marker employed to prognosticate mortality in neoplastic patients [22][23][24]. Among the fibrinolytic and coagulation factors present within the tumor microenvironment, fibrinogen and D-dimer, which also reflect tumor patients' inflammatory responses and coagulation aberrations, may serve as prognostic indicators for these individuals [25][26][27][28]. The albumin-to-fibrinogen (AFR) and albumin-to-D-dimer ratios (ADR) concurrently capture the inflammatory, nutritional, and coagulation status of cancer patients, potentially offering superior prognostic accuracy compared to albumin, fibrinogen, and D-dimer in isolation.…”