Preoperative D-dimer and 5-year overall survival rate in patients diagnosed with gastric cancer and undergoing gastric cancer radical surgery: a Retrospective cohort study

Abstract

Background As one of the most malignant tumors of the digestive tract, gastric cancer has a high incidence rate and mortality rate in recent years, and lacks significant prognostic indicators. D-dimer, as a degradation product of fibrin, is a conventional biomarker for coagulation and has been studied to have potential promoting effects on postoperative cancer patients. However, there are also contradictory results, with some studies reporting a promoting effect, while others have not shown any effect. Therefore, the actual impact of D-dimer on the prognosis of postoperative cancer patients remains controversial, and further research is needed on the linear and nonlinear regression relationship and optimal critical values between D-dimer and postoperative cancer patients before surgery. Therefore, our aim is to evaluate the relationship between preoperative D-dimer and 5-year overall survival in patients undergoing gastric cancer radical surgery. Methods We used patients diagnosed with gastric cancer and underwent radical gastrectomy at Shanxi Cancer Hospital (Cancer Hospital of the Chinese Academy of Medical Sciences) in 2017 to explore the relationship between preoperative D-dimer and prognosis of gastric cancer. We obtained preoperative D-dimer data and tumor related indicators as covariates from the hospital medical record system, and obtained patient follow-up information from the hospital follow-up system. This study used multivariate Cox regression, curve fitting, and inflection point analysis to explore the correlation between preoperative D-dimer and 5-year overall survival after gastric cancer radical surgery. Results After strict admission and exclusion procedures, a total of 133 patients were included in the study, and we classified them based on D-dimer. Divide D-dimer into two groups on average: high group (n = 66) and low group (n = 67). Subsequently, Cox multiple regression analysis was conducted using both continuous and binary variables. Therefore, the results showed no effect in continuous variables, but significant presence in categorical variables (Table 3). Therefore, we performed curve fitting, and in the curve fitting, preoperative D-dimer. The relationship between dimer and 5-year survival rate after radical gastrectomy for cancer shows a U-shaped or J-shaped curve with p < 0.001 (Fig. 2). Prove a curved relationship between preoperative D-dimer and 5-year survival rate after radical gastrectomy for cancer. Subsequently, we conducted an inflection point analysis (Table 2) (Fig. 2), BK. Hour: 110.449 (106.956 ,113.942). Conclusion In patients undergoing radical gastrectomy for gastric cancer, preoperative D-dimer There is a U-shaped relationship between dimer and 5-year postoperative survival in gastric cancer.