Preoperative plasma D-dimer predicts one-year survival in colorectal cancer patients with absence of VTE: a prospective clinical cohort study

Mogens Tornby Stender, Torben Bjerregaard Larsen, Henrik Toft Sørensen, O Thorlacius-Ussing

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36 Citationer (Scopus)

Abstract

Background: Fibrin formation is required for tumour angiogenesis, metastasis and invasion. Cancer discovered at the same time as or shortly after venous thromboembolism (VTE) tends to be advanced, and the prognosis poor. Previous studies have demonstrated that plasma D-dimer - a degradation product of cross-linked fibrin - correlates with tumour stage and prognosis in patients with colorectal cancer. However, it remains unclear whether D-dimer is of prognostic significance in colorectal cancer patients with absence of VTE. Objective: To examine whether the preoperative plasma D-dimer level predicts one-year survival in pre- and postoperative VTE-negative colorectal cancer patients admitted for surgery. Methods: We measured preoperative D-dimer levels in 157 patients, and computed Kaplan-Meier survival curves according to the levels of D-dimer. Cox proportional-hazard regression analysis was used to compute hazard ratio as a measure of one-year mortality rate ratio, controlling for potential confounding factors. The Aalborg Hospital's standard cut-off level of 0.3 mg/L was used to distinguish negative and positive D-dimer results. Results: The overall one-year survival rate was 87.3% (95% confidence interval (CI): 81.0%- 91.6%) with 78.1% survival (95% CI: 65.9%- 86.4%) in the positive D-dimer group compared with 93.6% survival (95% CI: 86.2%- 97.1% percent) in the negative D-dimer group. The adjusted hazard ratio of death in the positive D-dimer group compared to the negative D-dimer group was 3.6 (95% CI: 1.3 - 9.9). Conclusion: A positive preoperative D-dimer is associated with a poor prognosis in colorectal cancer patients with absence of VTE. © 2012 International Society on Thrombosis and Haemostasis.
OriginalsprogEngelsk
TidsskriftJournal of Thrombosis and Haemostasis
Vol/bind10
Sider (fra-til)2027-31
Antal sider5
ISSN1538-7933
DOI
StatusUdgivet - 2012
Udgivet eksterntJa

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