Plasma D-dimer level as a mortality predictor in patients with advanced or recurrent colorectal cancer.
OBJECTIVE
Plasma D-dimer levels are elevated in patients with a variety of solid tumors. Recently, it has been reported that the level before curative surgery is a prognostic factor for colorectal cancer (CRC). We investigated whether the plasma D-dimer level before systemic chemotherapies is a predictor for advanced or recurrent unresectable CRC.


METHODS
This study included 42 patients treated with systemic chemotherapies for advanced or recurrent unresectable CRC. Variables including clinicopathological factors, plasma D-dimer levels and the modified Glasgow Prognostic Factor Score (mGPS) were evaluated.


RESULTS
The plasma D-dimer level was closely related to the mGPS. Survival was shorter for patients with plasma D-dimer levels >5 µg/ml than for those with lower levels. Compared with an mGPS of 0 or 1, an mGPS of 2 was predictive of poor prognosis (p < 0.0001). Old age, advanced stage, plasma D-dimer level and mGPS were significantly associated with mortality, but plasma D-dimer level was the only independent risk factor in multivariate analysis, and was significant related to the clinical response to chemotherapy (p < 0.05).


CONCLUSIONS
Survival was significantly shorter in patients with elevated plasma D-dimer levels having advanced or recurrent CRC. The plasma D-dimer level before systemic chemotherapies was an independent mortality predictor.
Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan. yamamoto-m@yahata.saiseikai.or.jp
Manabu
M
Yamamoto
Keiji
K
Yoshinaga
Ayumi
A
Matsuyama
Tokiomi
T
Iwasa
Atsushi
A
Osoegawa
Eiji
E
Tsujita
Yoichi
Y
Yamashita
Shinichi
S
Tsutsui
Teruyoshi
T
Ishida
D000368:Aged; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D