title: D-Dimer Can Serve as a Prognostic and Predictive Biomarker for Metastatic Gastric Cancer Treated by Chemotherapy.
abstract: Systemic activation of hemostasis and thrombosis has been implicated in tumor progression and metastasis. D-dimer has been used as an indicator for the thrombosis. Here, we investigated the role of the activation of coagulation in patients with metastatic gastric cancer by measuring D-dimer level.We conducted an observation study of 46 metastatic gastric cancer patients who received palliative chemotherapy (CTx). D-dimer levels were assessed before CTx and at the first response evaluation after CTx.The overall survival (OS) of patients with pretreatment D-dimer levels <1.5 μg/mL was significantly longer than that of patients with D-dimer levels ≥1.5 μg/mL (22.0 vs 7.9 months, P = 0.019). At the first response evaluation, the mean level of D-dimer was significantly decreased by 2.11 μg/mL in patients either with partial response or stable disease (P = 0.011) whereas the mean level of D-dimer, although the difference did not reach statistical significance, was increased by 2.46 μg/mL in patients with progressive disease. In addition, the OS of patients with D-dimer levels <1.0 μg/mL at the first response evaluation was significantly longer than that of patients with D-dimer levels ≥1.0 μg/mL (22.0 vs 7.0 months, P = 0.009). The lower D-dimer levels (<1.0 μg/mL) at the first response evaluation after CTx was independent predictive factor for better survival in multivariate analysis (P = 0.037).This study suggests that D-dimer levels may serve as a biomarker for response to CTx and OS in patients with metastatic gastric cancer.
authors.affiliation: From the Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea (S-IG, MJL, WSL, HJC, USL, MHK, H-GK, G-WL, JHK); Department of Preventive Medicine and Environmental Health Center, Gyeongsang National University School of Medicine, Jinju, Korea (RBK), Department of Pathology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea (JHL); and Department of Laboratory Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea (SJK).
authors.forename: Se-Il
authors.initials: SI
authors.lastname: Go
authors.forename: Min Jeong
authors.initials: MJ
authors.lastname: Lee
authors.forename: Won Sup
authors.initials: WS
authors.lastname: Lee
authors.forename: Hye Jung
authors.initials: HJ
authors.lastname: Choi
authors.forename: Un Seok
authors.initials: US
authors.lastname: Lee
authors.forename: Rock Bum
authors.initials: RB
authors.lastname: Kim
authors.forename: Myoung Hee
authors.initials: MH
authors.lastname: Kang
authors.forename: Hoon-Gu
authors.initials: HG
authors.lastname: Kim
authors.forename: Gyeong-Won
authors.initials: GW
authors.lastname: Lee
authors.forename: Jung Hun
authors.initials: JH
authors.lastname: Kang
authors.forename: Jeong-Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Sun Joo
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000097:blood / Q000188:drug therapy / Q000556:secondary*
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D