Document Detail


High plasma D-dimer level is associated with decreased survival in patients with lung cancer.
MedLine Citation:
PMID:  17513096     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: An elevated plasma D-dimer level indicates the activation of coagulation and fibrinolysis. In the present study, we investigated the association of pre-treatment haemostatic parameters (D-dimer, fibrinogen and prothrombin fragment 1+2) with clinicopathological parameters and outcome in patients with lung cancer. MATERIALS AND METHODS: Plasma levels of D-dimer and other parameters were measured in 78 evaluable patients with lung cancer (60 non-small cell lung cancers, 18 small cell lung cancers). At diagnosis, 35 patients (44.9%) were locally advanced stage (IIIA/B) and 43 patients (55.1%) had metastatic disease (IV). Multivariate statistical analysis was carried out using Cox's proportional hazards model. The receiver operating characteristic curve was used to determine the cut-off values for D-dimer, fibrinogen and prothrombin fragment 1+2. RESULTS: The median survival for all patients was 264 days (95% confidence interval 200-328 days). A significant association between the plasma levels of D-dimer and the response to chemotherapy was observed (P=0.03). With the univariate analysis, tumour stage, pre-treatment plasma levels of D-dimer, fibrinogen, platelet count, lactate dehydrogenase concentration and Karnofsky performance status were predictive for survival. With the multivariate analysis (P< or =0.1), the plasma level of D-dimer (P<0.001), tumour stage (P=0.01) and Karnofsky performance status (P=0.02) were identified as independent predictive factors. The median survival times were 405 days (95% confidence interval 165-644 days) and 207 days (95% confidence interval 146-267 days, P<0.001), respectively, for patients with a low D-dimer level (< or =0.65 microg/ml) and a high D-dimer level (>0.65 microg/ml). CONCLUSIONS: Elevated plasma levels of D-dimer in patients with lung cancer are associated with decreased survival and a poor response to treatment. Pre-treatment for the D-dimer level may be useful in the prediction of survival and the response to treatment.
Authors:
G Altiay; A Ciftci; M Demir; Z Kocak; N Sut; E Tabakoglu; O N Hatipoglu; T Caglar
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2007-05-21
Journal Detail:
Title:  Clinical oncology (Royal College of Radiologists (Great Britain))     Volume:  19     ISSN:  0936-6555     ISO Abbreviation:  Clin Oncol (R Coll Radiol)     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-06     Completed Date:  2007-10-18     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  9002902     Medline TA:  Clin Oncol (R Coll Radiol)     Country:  England    
Other Details:
Languages:  eng     Pagination:  494-8     Citation Subset:  IM    
Affiliation:
Department of Chest Disease, Trakya University Hospital, 22030 Edirne, Turkey. gundeniza@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Carcinoma, Non-Small-Cell Lung / blood*,  drug therapy,  mortality*
Carcinoma, Small Cell / blood*,  drug therapy,  mortality*
Female
Fibrin Fibrinogen Degradation Products / analysis*
Fibrinogen / analysis
Humans
Lung Neoplasms / blood*,  drug therapy,  mortality*
Male
Middle Aged
Prognosis
Survival Analysis
Chemical
Reg. No./Substance:
0/Fibrin Fibrinogen Degradation Products; 9001-32-5/Fibrinogen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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