Preoperative plasma D-dimer level is a useful prognostic marker in ovarian cancer.

Abstract

A high pre-treatment plasma D-dimer level was recently identified as a poor prognostic factor in several malignancies. The aim of this study was to evaluate the prognostic significance of plasma D-dimer levels in epithelial ovarian cancer (EOC). Data of 199 patients were retrospectively analysed. The relationships between pre-treatment D-dimer levels and other clinical parameters and prognosis were evaluated. Univariate analysis identified age, pre-treatment plasma D-dimer level, massive ascites, residual tumours, pre-treatment CA125 level, histological type, and FIGO stage as predictors of overall survival. The multivariate analysis showed that a high pre-treatment plasma D-dimer level (p=.017), residual tumours (p < .001), and FIGO stage (p = .036) were independent risk factors of overall survival. Venous thromboembolism (VTE) did not influence overall survival (p=.091). High pre-treatment D-dimer levels are associated with a poor prognosis independent of VTE status in EOC patients, and might be a useful prognostic biomarker.Impact statementWhat is already known on this subject? In recent years, a high pre-treatment plasma D-dimer level has been identified as a prognostic factor in several malignancies, but only a handful of studies have assessed the role of pre-treatment plasma D-dimer levels in patients with EOC patients. Thus, the clinical significance and prognostic value of the plasma D-dimer level in EOC remain controversial, and there is also debate related to the association of the higher mortality rate among cancer patients with elevated D-dimer levels with VTE.What do the results of this study add? In our study, high pre-treatment D-dimer levels are associated with a poor prognosis independently of VTE in EOC patients.What are the implications of these findings for clinical practice and/or further research? The D-dimer level might emerge as a valuable prognostic biomarker, which will help doctors in the choice of initiating a more aggressive therapy, the combination of chemotherapy with anticoagulation therapy.

• Authors: Yuki Yamada, Ryuji Kawaguchi, Kana Iwai, Emiko Niiro, Sachiko Morioka, Yasuhito Tanase, Hiroshi Kobayashi
• Journal: Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology (J Obstet Gynaecol) Vol. 40 Issue 1 Pg. 102-106 (Jan 2020) ISSN: 1364-6893 [Electronic] England
• PMID: 31335252 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Biomarkers, Tumor
• CA-125 Antigen
• Fibrin Fibrinogen Degradation Products
• fibrin fragment D

Topics

• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor (blood)
• CA-125 Antigen (blood)
• Carcinoma, Ovarian Epithelial (blood, mortality, surgery)
• Female
• Fibrin Fibrinogen Degradation Products (analysis)
• Humans
• Middle Aged
• Neoplasm, Residual
• Ovarian Neoplasms (blood, mortality, surgery)
• Preoperative Period
• Prognosis
• Retrospective Studies
• Risk Factors
• Survival Rate
• Venous Thromboembolism (diagnosis, etiology)