title: High Pretreatment Plasma D-dimer Levels Are Associated With Poor Prognosis in Patients With Ovarian Cancer Independently of Venous Thromboembolism and Tumor Extension.
abstract: OBJECTIVE
  Elevated plasma D-dimer (DD) is associated with decreased survival among patients with breast, lung, and colon cancers. The present study clarifies the prognostic significance of pretreatment plasma DD levels in patients with epithelial ovarian cancer (EOC).
  
  
  METHODS
  We investigated pretreatment DD levels and other variables for overall survival using univariate and multivariate analyses in 134 consecutive patients with EOC stages II to IV who were initially treated between November 2004 and December 2010.
  
  
  RESULTS
  The median follow-up period was 53 (7-106) months. Univariate analysis significantly associated elevated pretreatment DD (≥2.0 μg/mL) levels to poor 5-year overall survival rates irrespective of previously treated venous thromboembolism (72.2% vs 52.6%, P = 0.039). Cancer antigen 125 levels of 200 U/mL or higher (P = 0.011), distant metastases (P = 0.0004), residual tumors (P < 0.0001), and International Federation of Gynecology and Obstetrics stage III/IV (P = 0.0033) were also poor prognostic factors. Multivariate analysis independently associated DD levels of 2.0 μg/mL or higher (P = 0.041), distant metastases (P = 0.013), and residual tumors (P < 0.0001) with poor overall survival.
  
  
  CONCLUSIONS
  High pretreatment DD levels are associated with poor overall survival in patients with EOC independently of venous thromboembolism and tumor extension and might comprise a promising prognostic biomarker for patients with EOC.
authors.affiliation: Departments of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Sakurai
authors.forename: Toyomi
authors.initials: T
authors.lastname: Satoh
authors.forename: Koji
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Hiroo
authors.initials: H
authors.lastname: Michikami
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Sari
authors.initials: S
authors.lastname: Nakao
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ochi
authors.forename: Mamiko
authors.initials: M
authors.lastname: Onuki
authors.forename: Takeo
authors.initials: T
authors.lastname: Minaguchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshikawa
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000097:blood / Q000401:mortality* / Q000473:pathology; D002288:Adenocarcinoma, Mucinous / Q000097:blood / Q000401:mortality* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018284:Cystadenocarcinoma, Serous / Q000097:blood / Q000401:mortality* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000097:blood / Q000401:mortality* / Q000473:pathology; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000097:blood / Q000401:mortality* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000097:blood / Q000401:mortality* / Q000473:pathology; D011379:Prognosis; D015996:Survival Rate; D054556:Venous Thromboembolism / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D