M. Oya et al., High preoperative plasma D-dimer level is associated with advanced tumor stage and short survival after curative resection in patients with colorectal cancer, JPN J CLIN, 31(8), 2001, pp. 388-394
Background: An elevated plasma D-dimer level indicates activation of coagul
ation and fibrinolysis. Previous studies demonstrated that the preoperative
plasma D-dimer level correlates with tumor stage in patients with colorect
al cancer. This study examined the relationship between preoperative plasma
D-dimer level and both pathological findings and TNM classification and ex
amined the prognostic significance of preoperative plasma D-dimer level.
Methods: Preoperative plasma D-dimer levels were measured in 93 patients wh
o underwent curative resection of colorectal cancer and 40 patients with be
nign colorectal diseases other than inflammatory bowel disease. The results
were analyzed for correlations between preoperative plasma D-dimer levels
in patients with colorectal cancer and pathological findings, TNM classific
ation and postoperative survival.
Results: Preoperative plasma D-dimer levels were significantly higher in pa
tients with colorectal cancer than in patients with benign colorectal disea
ses. Plasma D-dimer levels were higher in patients with tumors that were re
latively large, had relatively deep wall penetration and were at a relative
ly advanced TNM stage. Higher preoperative plasma D-dimer levels were signi
ficantly associated with shorter postoperative overall survival. Results of
analysis with a multivariate proportional hazard model suggested that preo
perative plasma D-dimer level was the third strongest prognostic factor; ex
ceeded in importance only by lymph node status and preoperative carcinoembr
yonic antigen level.
Conclusions: Elevated plasma D-dimer levels in patients with colorectal can
cer are associated with relatively advanced tumor stage and short postopera
tive survival after curative resection. It appears that measurement of preo
perative D-dimer level would be useful in the preoperative diagnosis of tum
or stage and prediction of postoperative survival.