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D-Dimer Can Serve as a Prognostic and Predictive Biomarker for Metastatic Gastric Cancer Treated by Chemotherapy.

Go SI, Lee MJ, Lee WS, Choi HJ, Lee US, Kim RB, Kang MH, Kim HG, Lee GW, Kang JH, Lee JH, Kim SJ - Medicine (Baltimore) (2015)

Bottom Line: D-dimer levels were assessed before CTx and at the first response evaluation after CTx.The overall survival (OS) of patients with pretreatment D-dimer levels <1.5 μg/mL was significantly longer than that of patients with D-dimer levels ≥1.5 μg/mL (22.0 vs 7.9 months, P = 0.019).At the first response evaluation, the mean level of D-dimer was significantly decreased by 2.11 μg/mL in patients either with partial response or stable disease (P = 0.011) whereas the mean level of D-dimer, although the difference did not reach statistical significance, was increased by 2.46 μg/mL in patients with progressive disease.In addition, the OS of patients with D-dimer levels <1.0 μg/mL at the first response evaluation was significantly longer than that of patients with D-dimer levels ≥1.0 μg/mL (22.0 vs 7.0 months, P = 0.009).

View Article: PubMed Central - PubMed

Affiliation: From the Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea (S-IG, MJL, WSL, HJC, USL, MHK, H-GK, G-WL, JHK); Department of Preventive Medicine and Environmental Health Center, Gyeongsang National University School of Medicine, Jinju, Korea (RBK), Department of Pathology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea (JHL); and Department of Laboratory Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea (SJK).

ABSTRACT
Systemic activation of hemostasis and thrombosis has been implicated in tumor progression and metastasis. D-dimer has been used as an indicator for the thrombosis. Here, we investigated the role of the activation of coagulation in patients with metastatic gastric cancer by measuring D-dimer level.We conducted an observation study of 46 metastatic gastric cancer patients who received palliative chemotherapy (CTx). D-dimer levels were assessed before CTx and at the first response evaluation after CTx.The overall survival (OS) of patients with pretreatment D-dimer levels <1.5 μg/mL was significantly longer than that of patients with D-dimer levels ≥1.5 μg/mL (22.0 vs 7.9 months, P = 0.019). At the first response evaluation, the mean level of D-dimer was significantly decreased by 2.11 μg/mL in patients either with partial response or stable disease (P = 0.011) whereas the mean level of D-dimer, although the difference did not reach statistical significance, was increased by 2.46 μg/mL in patients with progressive disease. In addition, the OS of patients with D-dimer levels <1.0 μg/mL at the first response evaluation was significantly longer than that of patients with D-dimer levels ≥1.0 μg/mL (22.0 vs 7.0 months, P = 0.009). The lower D-dimer levels (<1.0 μg/mL) at the first response evaluation after CTx was independent predictive factor for better survival in multivariate analysis (P = 0.037).This study suggests that D-dimer levels may serve as a biomarker for response to CTx and OS in patients with metastatic gastric cancer.

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Related in: MedlinePlus

Dot plot with the raw data for the relationship between D-dimer levels at pretreatment and at the first response evaluation.
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Figure 2: Dot plot with the raw data for the relationship between D-dimer levels at pretreatment and at the first response evaluation.

Mentions: Baseline characteristics of 46 patients according to pretreatment D-dimer level are shown in Table 1. Median age and distribution of sex were not statistically different between the 2 groups, with male predominance (male and female ratio, 3.6:1). The site of metastasis was similarly distributed between the 2 groups. However, poorly differentiated histology was associated with high pretreatment D-dimer level (P = 0.048). The number of CTx cycles was similar between the 2 groups. However, pretreatment D-dimer levels appeared to be higher in the patients showing progressive disease (PD) after CTx, but statistically insignificant. The thrombosis during CTx occurred with similar frequency between the 2 groups. Among 7 patients with thrombosis during CTx, 2 had pulmonary thromboembolism, 1 had deep vein thrombosis of right common femoral vein, 3 had other VTEs (1 left renal vein and 2 portal vein), and 1 had arterial thrombosis of lower abdominal aorta. Figure 2 shows the dot plot with the raw data of each patient for the relationship between D-dimer levels at pretreatment and at the first response evaluation. There was no close relationship between the 2 time points without statistical significance (P = 0.095).


D-Dimer Can Serve as a Prognostic and Predictive Biomarker for Metastatic Gastric Cancer Treated by Chemotherapy.

Go SI, Lee MJ, Lee WS, Choi HJ, Lee US, Kim RB, Kang MH, Kim HG, Lee GW, Kang JH, Lee JH, Kim SJ - Medicine (Baltimore) (2015)

Dot plot with the raw data for the relationship between D-dimer levels at pretreatment and at the first response evaluation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554111&req=5

Figure 2: Dot plot with the raw data for the relationship between D-dimer levels at pretreatment and at the first response evaluation.
Mentions: Baseline characteristics of 46 patients according to pretreatment D-dimer level are shown in Table 1. Median age and distribution of sex were not statistically different between the 2 groups, with male predominance (male and female ratio, 3.6:1). The site of metastasis was similarly distributed between the 2 groups. However, poorly differentiated histology was associated with high pretreatment D-dimer level (P = 0.048). The number of CTx cycles was similar between the 2 groups. However, pretreatment D-dimer levels appeared to be higher in the patients showing progressive disease (PD) after CTx, but statistically insignificant. The thrombosis during CTx occurred with similar frequency between the 2 groups. Among 7 patients with thrombosis during CTx, 2 had pulmonary thromboembolism, 1 had deep vein thrombosis of right common femoral vein, 3 had other VTEs (1 left renal vein and 2 portal vein), and 1 had arterial thrombosis of lower abdominal aorta. Figure 2 shows the dot plot with the raw data of each patient for the relationship between D-dimer levels at pretreatment and at the first response evaluation. There was no close relationship between the 2 time points without statistical significance (P = 0.095).

Bottom Line: D-dimer levels were assessed before CTx and at the first response evaluation after CTx.The overall survival (OS) of patients with pretreatment D-dimer levels <1.5 μg/mL was significantly longer than that of patients with D-dimer levels ≥1.5 μg/mL (22.0 vs 7.9 months, P = 0.019).At the first response evaluation, the mean level of D-dimer was significantly decreased by 2.11 μg/mL in patients either with partial response or stable disease (P = 0.011) whereas the mean level of D-dimer, although the difference did not reach statistical significance, was increased by 2.46 μg/mL in patients with progressive disease.In addition, the OS of patients with D-dimer levels <1.0 μg/mL at the first response evaluation was significantly longer than that of patients with D-dimer levels ≥1.0 μg/mL (22.0 vs 7.0 months, P = 0.009).

View Article: PubMed Central - PubMed

Affiliation: From the Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea (S-IG, MJL, WSL, HJC, USL, MHK, H-GK, G-WL, JHK); Department of Preventive Medicine and Environmental Health Center, Gyeongsang National University School of Medicine, Jinju, Korea (RBK), Department of Pathology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea (JHL); and Department of Laboratory Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea (SJK).

ABSTRACT
Systemic activation of hemostasis and thrombosis has been implicated in tumor progression and metastasis. D-dimer has been used as an indicator for the thrombosis. Here, we investigated the role of the activation of coagulation in patients with metastatic gastric cancer by measuring D-dimer level.We conducted an observation study of 46 metastatic gastric cancer patients who received palliative chemotherapy (CTx). D-dimer levels were assessed before CTx and at the first response evaluation after CTx.The overall survival (OS) of patients with pretreatment D-dimer levels <1.5 μg/mL was significantly longer than that of patients with D-dimer levels ≥1.5 μg/mL (22.0 vs 7.9 months, P = 0.019). At the first response evaluation, the mean level of D-dimer was significantly decreased by 2.11 μg/mL in patients either with partial response or stable disease (P = 0.011) whereas the mean level of D-dimer, although the difference did not reach statistical significance, was increased by 2.46 μg/mL in patients with progressive disease. In addition, the OS of patients with D-dimer levels <1.0 μg/mL at the first response evaluation was significantly longer than that of patients with D-dimer levels ≥1.0 μg/mL (22.0 vs 7.0 months, P = 0.009). The lower D-dimer levels (<1.0 μg/mL) at the first response evaluation after CTx was independent predictive factor for better survival in multivariate analysis (P = 0.037).This study suggests that D-dimer levels may serve as a biomarker for response to CTx and OS in patients with metastatic gastric cancer.

Show MeSH
Related in: MedlinePlus