title: A Novel Clinical Factor, D-Dimer Platelet Multiplication, May Predict Postoperative Recurrence and Prognosis for Patients with Cholangiocarcinoma.
abstract: Patients with cholangiocarcinoma (CC) have a poor prognosis, and their postoperative survival depends on cancer progression and recurrence. Thus, prognostic markers are needed. The fibrin cleavage product, D-dimer, is associated with malignant progression and recurrence in various cancers, and platelets also are related to tumor progression. This study therefore evaluated a new prognostic factor, D-dimer platelet multiplication (PDM), for predicting prognosis in cases of CC.
  
  
  
  This study retrospectively evaluated 55 cases to determine the correlations of D-dimer, platelet, and PDM levels with patient survival. The cutoff values for D-dimer, platelets, and PDM levels were determined using receiver operating characteristic curve analyses.
  
  
  
  The recurrence group exhibited significantly higher D-dimer (P = 0.00075) and PDM (P = 0.0000683) levels and a trend toward higher platelet levels (P = 0.117). The optimal cutoff values were 1.3 µg/mL for D-dimer levels, 245 × 104/µL for platelet levels, and 158.2 × 104 µg/mL × µL for PDM levels. Poor recurrence-free survival was associated with high D-dimer levels (P = 0.0428), high platelet levels (P = 0.0498), and high PDM levels (P = 0.00511). Poor cancer-specific survival was associated with high platelet levels (P = 0.0156) and high PDM levels (P = 0.0156). In the multivariate analysis, PDM had the greatest correlation with CC prognosis and independently predicted recurrence (P = 0.00649).
  
  
  
  High D-dimer, platelet, and PDM levels were associated with poor recurrence-free and cancer-specific survivals, with PDM exhibiting the greatest correlation with prognosis. Therefore, PDM may help to predict recurrence and prognosis for patients with CC.
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Watanabe
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan. karaki@gunma-u.ac.jp.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Araki
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan.
authors.forename: Keitarou
authors.initials: K
authors.lastname: Hirai
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Kubo
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan.
authors.forename: Takamichi
authors.initials: T
authors.lastname: Igarashi
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Tsukagoshi
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Ishii
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan.
authors.forename: Kouki
authors.initials: K
authors.lastname: Hoshino
authors.affiliation: Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, Maebashi Gunma, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001650:Bile Duct Neoplasms / Q000097:blood* / Q000601:surgery; D018281:Cholangiocarcinoma / Q000097:blood* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D010976:Platelet Count; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D