Prognostic value of pretreatment D-dimer level in small-cell lung cancer: a meta-analysis

Abstract

Purpose To determine the prognostic significance of pretreatment D-dimer level in predicting clinical outcomes, such as the overall survival (OS) and progression-free survival (PFS), of patients with small cell lung cancer (SCLC). Methods A systematic search in PubMed, Web of Science, EMBASE, Cochrane Library, CNKI, SinoMed, Wanfang and VIP databases was performed to identify available studies. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were applied to assess the association of pretreatment D-dimer level with prognosis of SCLC patients. All statistical analyses were conducted via the STATA 12.0 version software. Results A total of 7 studies involving 964 patients were included in this meta-analysis and all patients were from China. The results showed that elevated pretreatment D-dimer level was significantly correlated with worse OS(HR=1.90, 95% CI: 1.55-2.34, P <0.001) and PFS (HR=1.52, 95% CI: 1.24-1.85, P ＜0.001). Subgroup analyses based on the treatment, D-dimer cut-off, detection method and source of HR were also performed to further verify the prognostic value of pretreatment D-dimer level in SCLC. Conclusions Pretreatment blood concentration of D-dimer may deserve as a reliable factor to predict prognosis of Chinese patients with SCLC. More well-designed prospective studies with big samples are still needed to verify our findings.