Prognostic and predictive value of plasma D-dimer in advanced non-small cell lung cancer patients undergoing first-line chemotherapy

Ge, Li‐Ping; Li, J.; Bao, Qian-Lei; Chen, P.; Jiang, Qian; Zhu, Liangjun

doi:10.1007/s12094-014-1198-2

Cited by 28 publications

(23 citation statements)

References 28 publications

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“…D-dimer is a clinically common marker of activation of coagulation system. Increasing evidence showed that malignant neoplasm could promote the activation of coagulation, and elevated D-dimer was detected in several cancers which correlated to the prognosis, including in lung cancer, gastric cancer, and colorectal cancer [ 27 – 29 ]. Ma et al have demonstrated high D-dimer predicted worse survival in lung cancer by a meta-analysis [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

High pretreatment plasma D-dimer predicts poor survival of colorectal cancer: insight from a meta-analysis of observational studies

Tong

et al. 2017

Oncotarget

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D-dimer, one of the canonical markers of hypercoagulability, was reported to be a potential prognostic marker of colorectal cancer. However, an inconsistent conclusion existed in several published studies. Thus, we performed this meta-analysis to provide a comprehensive insight into the prognostic role for pretreatment D-dimer in colorectal cancer. Six databases (English: Pubmed, Embase and Web of Science; Chinese: CNKI, Wangfang and VIP) were utilized for the literature retrieval. Hazard ratio (HR) was pooled by Stata 12.0. A total of fifteen studies (2283 cases) corresponded to this meta-analysis and provided available data to evaluate the prognostic role of D-dimer for colorectal cancer. The pooled HR reached 2.167 (95%. CI (confidence interval): 1.672–2.809, P < 0.001) utilizing random effect model due to obvious heterogeneity among the included studies (I2: 73.3%; P < 0.001). To explore the heterogeneity among the studies, we conducted a sensitivity analysis and found a heterogeneous study. After removing it, the heterogeneity reduced substantially (I2: 0%; P = 0.549) and we obtained a more convincing result by fixed effect model (HR = 2.143, 95% CI = 1.922–2.390, P < 0.001, 14 studies with 2179 cases). In summary, high pretreatment plasma D-dimer predicts poor survival of colorectal cancer based on the current evidence. Further prospective researches are necessary to confirm the role of D-dimer in colorectal cancer.

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Section: Discussionmentioning

confidence: 99%

High pretreatment plasma D-dimer predicts poor survival of colorectal cancer: insight from a meta-analysis of observational studies

Tong

et al. 2017

Oncotarget

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“…D-dimer plasma levels that is an inexpensive, easy and noninvasive method may be useful in predicting clinical outcome, survival and treatment response of patients with lung cancer [6]. The positivity of D-dimer before and during chemotherapy was a predictor of treatment response and worse progression-free survival providing prognostic information in patients with advanced non-small cell lung cancer (NSCLC) [7]. Likewise, an elevated plasma D-dimer level could be served as an independent determinant of poor prognosis in patients with small cell lung cancer(SCLC) [8].…”

Section: Introductionmentioning

confidence: 99%

The relationship between tumor markers and pulmonary embolism in lung cancer

Xiong

Zhao

et al. 2017

Oncotarget

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BackgroundTumor markers (TMs) and D-Dimer are both hallmarks of severity and prognosis of lung cancer. Tumor markers could be related to pulmonary embolism (PE) in lung cancer.ResultsThe number of abnormal tumor markers of lung cancer patients with pulmonary embolism (3.9 ± 1.1vs1.6 ± 0.6,P 0.005) was more than that in patients without pulmonary embolism. TMs panel (P trend < 0.001), CEA (R2 0.735, P0.003) and CYFRA21-1 (R2 0.718, P0.005) were positively correlated with D-Dimer in patients with pulmonary embolism. The multivariate logistic regression analysis showed that, for tumor markers, TMs panel (OR5.98, P < 0.001) had the strongest correlation with pulmonary embolism. The AUC (area under curve) of TMs panel and CEA were 0.82 [95%CI (0.71–0.95), P < 0.001] and 0.71 [95%CI (0.62–0.84), P 0.002] by ROC (receiver operating characteristic) curve analysis, respectively.Materials and MethodsTumor markers were compared between lung cancer patients complicated with pulmonary embolism and those without pulmonary embolism Then the correlation between each tumor marker as well as panel of combined TMs and D-Dimer as well as pulmonary embolism were analyzed for patients with pulmonary embolism.ConclusionsThere is a relationship between tumor markers and pulmonary embolism in patients with lung cancer. The panel of combined tumor markers is a valuable diagnostic marker for pulmonary embolism in lung cancer.

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“…Although for what length of time high levels of D-dimer remain varies among studies, [33][34][35] mainly caused by inconsistent follow-up period in different researches, we hypothesized that for surgical patients, the high levels of D-dimer will reduce to baseline status within a month, which is shorter than those additionally receiving subsequent adjuvant chemotherapy. 24 D-dimer levels were higher than baseline in patients who developed VTE after surgery, and studies have shown that preoperative levels of D-dimer had an impact on survival of NSCLC patients. 16 However, it seems irresponsible to omit the fluctuations of D-dimer levels after surgery.…”

Section: Discussionmentioning

confidence: 98%

“…Considering that D-dimer elevation can be detected in many circumstances such as tumor, surgery, chemoradiotherapy, inflammation, advanced age and so on, 23 the levels of Ddimer should be undulatory when cancer patients undergo such antitumor therapy as surgery or chemoradiotherapy. 24 Evaluating the dynamic change of D-dimer in combination with clinical risk factors and its association with the incidence of postoperative VTE can help surgeons better hierarchically manage patients and recognize those with a high risk of developing thrombotic events postoperatively. As there are few results on how the D-dimer concentration changes in patients surgically treated in the thoracic department, in this study, we shed light on the dynamics of D-dimer in NSCLC patients receiving radical surgical treatment and investigate the relationship between Ddimer and VTE within certain groups of patients.…”

Section: Introductionmentioning

confidence: 99%

Dynamics of D‐dimer in non‐small cell lung cancer patients receiving radical surgery and its association with postoperative venous thromboembolism

Cui

Chen

et al. 2020

Thoracic Cancer

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Background Venous 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. Methods In 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. Results VTE 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). Conclusions D‐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 points Significant 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 adds Risk‐stratified D‐dimer cutoff values adjusted to surgical methods and disease stages would benefit the exclusion of postoperative venous thromboembolism.

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Prognostic and predictive value of plasma D-dimer in advanced non-small cell lung cancer patients undergoing first-line chemotherapy

Abstract: The positivity of D-dimer before and during chemotherapy is a predictor of treatment response and worse PFS in patients with advanced NSCLC. D-dimer levels provide prognostic information in addition to that of imaging studies.

Cited by 28 publications

References 28 publications

High pretreatment plasma D-dimer predicts poor survival of colorectal cancer: insight from a meta-analysis of observational studies

High pretreatment plasma D-dimer predicts poor survival of colorectal cancer: insight from a meta-analysis of observational studies

The relationship between tumor markers and pulmonary embolism in lung cancer

Dynamics of D‐dimer in non‐small cell lung cancer patients receiving radical surgery and its association with postoperative venous thromboembolism

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