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D-dimer predicts postoperative recurrence and prognosis in patients with liver metastasis of colorectal cancer

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Abstract

Background

Colorectal cancer is common, and its incidence is increasing throughout the world. The liver is a major metastatic site, and colorectal liver metastasis (CRLM) has a poor prognosis. Although liver resection is the most effective therapy for CRLM, postoperative recurrence is common. Thus, prognostic markers for CRLM are greatly needed. D-dimer, a fibrin cleavage product, has been shown to be related to colorectal tumor progression, and is also associated with malignant progression and recurrence in various cancers. Therefore, we evaluated the value of D-dimer in predicting the prognosis in CRLM.

Methods

We retrospectively evaluated 90 cases of resected CRLM to determine the correlation between D-dimer and patient survival. The cut-off value for D-dimer levels was determined using receiver operating characteristic curve analysis.

Results

Significant differences occurred in the recurrence group with higher D-dimer levels (P = 0.00736*), while the optimal cut-off value was 0.6 µg/mL. High D-dimer levels (≥ 0.6 µg/mL) were associated with poor recurrence-free survival (RFS; P = 0.0000841*) and cancer-specific survival (CSS; P = 0.00615*). In the multivariate analysis, D-dimer correlated with CRLM prognosis and independently predicted RFS (P = 0.0179*).

Conclusion

High D-dimer levels were associated with poor RFS and CSS. D-dimer was an independent prognostic factor of RFS. Therefore, D-dimer may help predict recurrence and prognosis in patients with CRLM.

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Abbreviations

CRLM:

Colorectal liver metastasis

CEA:

Carcinoembryonic antigen

ROC:

Receiver operating characteristic

VTE:

Venous thrombosis

NLR:

Neutrophil/lymphocyte ratio

mGPS:

Modified Glasgow Prognostic Score

RFS:

Recurrence-free survival

CSS:

Cancer-specific survival

CTCs:

Circulating tumor cells

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Acknowledgements

We thank Ms. Yukie Saito, Ms. Tomoko Yano, Ms. Tomoko Ubukata, and Ms. Yuki Saka for their excellent assistance.

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Authors and Affiliations

  1. Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Akira Watanabe, Kenichiro Araki, Norihumi Harimoto, Norio Kubo, Takamichi Igarashi, Norihiro Ishii, Takahiro Yamanaka, Kei Hagiwara & Ken Shirabe

  2. Department of General Surgical Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Hiroyuki Kuwano

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  1. Akira Watanabe
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  2. Kenichiro Araki
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Correspondence to Akira Watanabe.

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Watanabe, A., Araki, K., Harimoto, N. et al. D-dimer predicts postoperative recurrence and prognosis in patients with liver metastasis of colorectal cancer. Int J Clin Oncol 23, 689–697 (2018). https://doi.org/10.1007/s10147-018-1271-x

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  • DOI: https://doi.org/10.1007/s10147-018-1271-x

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