title: High pretreatment plasma D-dimer levels are related to shorter overall survival in endometrial carcinoma.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the prognostic value of pretreatment plasma dimerized plasmin fragment D (D-dimer) levels in endometrial carcinoma after adjusting for venous thromboembolism (VTE).
  
  
  METHODS
  The relationships between the following clinical parameters from 110 patients were investigated: age, histological type, the International Federation of Gynecology and Obstetrics (FIGO) stage, tumor grade, pretreatment plasma D-dimer level, platelet count, fibrinogen, CA19-9, and CEA levels, progression-free survival (PFS), and overall survival (OS). A survival analysis was performed using the Kaplan-Meier method, and prognostic factors were assessed using Cox's proportional hazards regression model.
  
  
  RESULTS
  High pretreatment D-dimer levels were detected in 32% of cases. High D-dimer levels correlated with an advanced tumor stage, histological type, and tumor grade (P=0.001, P=0.021, P=0.044). A multivariate analysis identified high D-dimer levels as an independent prognostic factor for OS (P=0.013), whereas the histological type, but not D-dimer levels had independent prognostic value for PFS (P=0.225).
  
  
  CONCLUSIONS
  High pretreatment D-dimer levels have an impact on prognoses independently of VTE, and also have potential as markers to predict surgical outcomes in patients with endometrial carcinoma. Pretreatment D-dimer levels may contribute to the identification of high-risk populations for treatment decisions.
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan. Electronic address: kn88@med.shimane-u.ac.jp.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nakayama
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Ishikawa
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Katagiri
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan.
authors.forename: Toshiko
authors.initials: T
authors.lastname: Minamoto
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan.
authors.forename: Tomoka
authors.initials: T
authors.lastname: Ishibashi
authors.affiliation: Department of Organ Pathology, Shimane University School of Medicine, Izumo 6938501, Japan.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Ishikawa
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Sato
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Sanuki
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: Department of Organ Pathology, Shimane University School of Medicine, Izumo 6938501, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Komatsu-Fujii
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Kyo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D002277:Carcinoma / Q000097:blood* / Q000401:mortality* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000097:blood* / Q000401:mortality* / Q000473:pathology; D004717:Endometrium / Q000473:pathology; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged
chemical_list: D014408:Biomarkers, Tumor; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D
keywords: D-dimer; Endometrial carcinoma; Overall survival; Progression-free survival; VTE