title: Serum D-dimer as a prognostic marker in patients undergoing radiofrequency ablation of colorectal liver metastasis.
abstract: BACKGROUND
  Although traditionally used for coagulation disorders, there has been a recent interest in serum D-dimer as a tumor marker. The aim of this prospective study is to determine its value as a tumor marker in patients with colorectal liver metastasis.
  
  
  METHODS
  Between January 2000 and October 2007, 242 patients undergoing laparoscopic radiofrequency ablation (RFA) of colorectal liver metastasis were evaluated prospectively. The relationship of D-dimer levels to pre-ablation parameters, recurrence, and survival was prospectively assessed. All data are expressed as mean ± SEM.
  
  
  RESULTS
  Preoperative D-dimer levels correlated with liver tumor volume (p = .04) and CEA (p = .003). D-dimer levels increased by a mean of 11.4 ± 1.5 folds after RFA on POD#7 and returned to preoperative values in three months. The rate of the elevation of D-dimer values after RFA was related to tumor volume ablated. The median overall survival was six months for patients with preoperative D-dimer > 1,000 ng/ml vs. 32 months for patients with D-dimer < 1,000 ng/ml (p = .02). On multivariate analysis preoperative serum D-dimer was an independent predictor of overall survival along with CEA and liver tumor burden.
  
  
  CONCLUSIONS
  Serum D-dimer levels reflect liver tumor burden and independently predict survival in patients with colorectal liver metastasis undergoing RFA.
authors.affiliation: Endocrinology and Metabolism Institute, Division of Endocrine Surgery, Cleveland Clinic, Cleveland, OH 44195, USA.
authors.forename: Gurkan
authors.initials: G
authors.lastname: Tellioglu
authors.forename: Orhan
authors.initials: O
authors.lastname: Agcaoglu
authors.forename: Allan
authors.initials: A
authors.lastname: Siperstein
authors.forename: Eren
authors.initials: E
authors.lastname: Berber
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D017115:Catheter Ablation; D015179:Colorectal Neoplasms; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D047368:Tumor Burden
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D