Prognostic Value of Albumin to D-Dimer Ratio in Advanced Gastric Cancer

Abstract

Gastric cancer (GC) is one of the most common malignancies worldwide. Notably, patients with advanced GC have a poor prognosis and quality of life, prompting the need for further studies on its prognostic markers. Among these, albumin and D-dimer are often used as prognostic factors in the prediction of a variety of tumors. Moreover, the albumin to D-dimer ratio (ADR) may be an improved predictor of chemotherapy effect and survival compared to albumin and D-dimer alone, but few studies have investigated this issue. Thus, we explored the relationship between pretreatment ADR and prognosis in advanced GC treated with first-line chemotherapy. A total of 247 advanced unresectable GC patients treated with first-line chemotherapy were retrospectively included. The cut-off value for ADR was determined using the receiver operating characteristic (ROC) curve. The ADR had a cut-off value of 41.64. Compared to albumin and D-dimer alone, ADR had the highest area under curve (AUC) value (AUC = 0.730), followed by albumin (AUC = 0.659) and D-dimer (AUC = 0.719). Additionally, we found that patients with a low ADR (<41.64) had a lower disease control rate (77.9% vs. 92.5%, P < 0.01 ), shorter overall survival (OS) (271 vs. 389 days), and shorter progression-free survival (PFS) (118 vs. 192 days) than patients with a high ADR (≥41.64). Similar results were also found on subgroup analysis, and ADR was found to be an independent advanced GC prognostic factor on multivariate analysis (all P < 0.001 ). Low ADR was found to be correlated with poor therapeutic effects of chemotherapy and shortened OS and PFS. Therefore, pretreatment ADR may be a useful tool for predicting the effect of chemotherapy and prognosis in advanced GC patients treated with first-line chemotherapy.

The D-Dimer/Albumin Ratio Is a Prognostic Marker for Aneurysmal Subarachnoid Hemorrhage

“…In the present study, we used the DAR, which reflects the hypercoagulative status and malnutrition. DAR has been used as an independent prognostic marker in infections, malignancies, and other diseases [ 6 , 7 ], Therefore, it is not surprising that the multivariate analysis in this study revealed that DAR independently predicted poor aSAH outcomes better than D-dimer alone.…”

“…Several blood tests might help predict outcomes [ 3 ], including tests for D-dimer, where high levels indicated poor outcomes in aSAH, and albumin, where low levels have been associated with poor aSAH outcomes [ 4 , 5 ]. The D-dimer/albumin ratio (DAR) has been identified as an independent predictor of poor outcome in patients suffering from infection, malignancy and critical illness [ 6 , 7 ]. However, the prognostic value of the combination of D-dimer and albumin has not been evaluated in aSAH patients.…”

A novel prognostic model of gastric cancer patients based on cachexia status by using plasma exosome-derived miRNAs

“…The ratio of C-reactive protein and albumin levels re ects the prognosis of gastric cancer [30]. Similarly, combined D-dimer level may be useful for predicting patients' response to rst-line chemotherapy and prognosis of advanced gastric cancer [31]. Therefore, we combined cachexia diagnosis with serum biomarker assessment to predict gastric cancer prognosis and patient survival.…”

IL-6/IL-10 mRNA expression ratio in tumor tissues predicts prognosis in gastric cancer patients without distant metastasis

“…Based on the immunoblot-based data, HP infection accounted for 89% of the global GC 5 . It was estimated that there were approximately 1.2 million new GC cases worldwide in 2017 6 , indicating that one million cases may be related to HP infection. Surgical resection alone or combined with radiotherapy and chemotherapy is a mainstay of treatment and the only potential cure for GC.…”