Prognostic significance of preoperative plasma D-dimer level in patients with surgically resected clinical stage I non-small cell lung cancer: a retrospective cohort study

Abstract

BackgroundPlasma D-dimer level, a marker of hypercoagulation, has been reported to be associated with survival in several types of cancers. The present study aimed to evaluate the prognostic significance of preoperative D-dimer levels in patients with surgically resected clinical stage I non-small cell lung cancer (NSCLC).MethodsParticipants comprised 237 patients with surgically resected clinical stage I NSCLC. In addition to factors such as age, sex, and smoking status, the association between preoperative D-dimer level and survival was explored.ResultsPatients were divided into two groups according to D-dimer level: Group A, ≤ 1.0 μg/ml (n = 170); and Group B, > 1.0 μg/ml (n = 67). The 5-year recurrence-free survival rate was 81.6% for Group A and 66.6% for Group B (p < 0.001). The 5-year overall survival rate was 93.6% for Group A and 84.7% for Group B (p = 0.002). Multivariate survival analysis identified D-dimer level as an independent prognostic factor, along with age, maximum standardized uptake value of the primary tumor, and pathological stage.ConclusionsPreoperative D-dimer level is an independent prognostic factor in patients with surgically resected clinical stage I NSCLC.

Prognostic role of preoperative platelet, fibrinogen, and D‐dimer levels in patients with non‐small cell lung cancer: A multicenter prospective study

“…Jiang et al reported that preoperative D‐D positivity (> 0.55 mg/L) is a significant and independent predictor for unfavorable disease‐free survival in NSCLC patients . A recent study conducted by Kaoru et al also revealed that an elevated preoperative D‐D level (>1.0 mg/L) is significantly associated with poor recurrence‐free survival among stage I NSCLC patients . In our study, however, neither univariate nor multilevel analyses confirmed the prognostic significance of elevated preoperative D‐D.…”

“…8 A recent study conducted by Kaoru et al also revealed that an elevated preoperative D-D level (>1.0 mg/L) is significantly associated with poor recurrence-free survival among stage I NSCLC patients. 9 In our study, however, neither univariate nor multilevel analyses confirmed the prognostic significance of elevated preoperative D-D. We believe this can be explained by the low statistical power of our study. Moreover, other more potent prognostic factors may have overshadowed its effect in the multilevel analyses.…”

“…Previous research has shown that elevated platelet (PLT) count, fibrinogen (FIB) level, and D‐dimer (D‐D) level are all associated with poor prognosis in NSCLC patients, but the results have been inconsistent . The majority of these studies were retrospective single‐center cohorts with relatively small sample sizes.…”

“…Tumor cells can activate systemic coagulation through multiple pathways and induce hemostatic and fibrinolytic abnormalities, which in turn contribute to cancer angiogenesis and metastasis. 7 Previous research has shown that elevated platelet (PLT) count, fibrinogen (FIB) level, and D-dimer (D-D) level are all associated with poor prognosis in NSCLC patients, [8][9][10][11][12][13] but the results have been inconsistent. 14,15 The majority of these studies were retrospective single-center cohorts with relatively small sample sizes.…”

Elevated preoperative plasma D-dimer dose not adversely affect survival of gastric cancer after gastrectomy with curative intent: A propensity score analysis

“…It is reported that D-dimer can not only affect cellular signaling systems and promote cell proliferation, but also stimulate the cellular adhesion of tumor cells to endothelial cells, affect platelets and extracellular matrix, and ultimately, induce the growth and spread of tumors (3,4). Many studies have affirmed that high levels of plasma D-dimer were associated with advanced tumor stage and poor survival of cancer patients (5)(6)(7)(8)(9)(10)(11)(12). Several researches reported that preoperative plasma D-dimer level (PDL) was an independent prognostic factor in patients with completely resected nonsmall cell lung cancer (NSCLC) (5)(6)(7), and others confirmed that the prognosis was significantly influenced by the elevated PDL in patients with colorectal cancer (8)(9)(10), esophageal cancer (11), breast cancer (12) and so on.…”