TY - JOUR
T1 - Preoperative plasma D-dimer predicts one-year survival in colorectal cancer patients with absence of VTE
T2 - a prospective clinical cohort study
AU - Stender, Mogens Tornby
AU - Larsen, Torben Bjerregaard
AU - Sørensen, Henrik Toft
AU - Thorlacius-Ussing, O
N1 - © 2012 International Society on Thrombosis and Haemostasis.
PY - 2012
Y1 - 2012
N2 - 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.
AB - 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.
U2 - 10.1111/j.1538-7836.2012.04887.x
DO - 10.1111/j.1538-7836.2012.04887.x
M3 - Journal article
SN - 1538-7933
VL - 10
SP - 2027
EP - 2031
JO - Journal of Thrombosis and Haemostasis
JF - Journal of Thrombosis and Haemostasis
ER -