Postoperative D-dimer elevation affects tumor recurrence and the long-term survival in gastric cancer patients who undergo gastrectomy
INTRODUCTION: We retrospectively evaluated the blood coagulation activity using the D-dimer level in the early period after gastrectomy and investigated whether postoperative hypercoagulation affects tumor recurrence and long-term survival in gastric cancer patients.
METHODS: The study involved 650 patients who underwent curative resection for gastric cancer at Kanagawa Cancer Center between July 2009 and July 2013. They were divided into a low-D-dimer group (LD group) and high-D-dimer group (HD group) according to the median D-dimer level on postoperative day (POD) 7. The risk factors for overall survival (OS) and relapse-free survival (RFS) were identified.
RESULTS: Of the 448 enrolled patients, 218 were classified into the LD group and 230 into the HD group. The 5-year OS rates after surgery were 90.8% and 81.3% in the LD and HD groups, respectively (p < 0.001). The 5-year RFS rates after surgery were 89.9% and 76.1% in the LD and HD groups, respectively (p < 0.001). A high D-dimer level on POD 7 (≥ 4.9 μg/ml) was identified as an independent predictive factor for both the OS (hazard ratio [HR] 1.955, 95% confidence interval [CI] 1.158-3.303, p = 0.012) and RFS (HR 2.182, 95% CI 1.327-3.589, p = 0.002). Furthermore, hematological recurrence was significantly more frequent in the HD group than in the LD group (p = 0.014).
CONCLUSION: A high D-dimer level on POD 7 may predict tumor recurrence and the long-term survival in patients who undergo gastrectomy for locally advanced gastric cancer. Patients with an elevated postoperative D-dimer level need careful observation and diagnostic imaging to timely detect tumor recurrence.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
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| Enthalten in: |
International journal of clinical oncology - 25(2020), 4 vom: 21. Apr., Seite 584-594 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hara, Kentaro [VerfasserIn] |
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| Links: |
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| Themen: |
Biomarkers, Tumor |
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| Anmerkungen: |
Date Completed 02.07.2020 Date Revised 02.07.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s10147-019-01603-x |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM304659479 |
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| 245 | 1 | 0 | |a Postoperative D-dimer elevation affects tumor recurrence and the long-term survival in gastric cancer patients who undergo gastrectomy |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a INTRODUCTION: We retrospectively evaluated the blood coagulation activity using the D-dimer level in the early period after gastrectomy and investigated whether postoperative hypercoagulation affects tumor recurrence and long-term survival in gastric cancer patients | ||
| 520 | |a METHODS: The study involved 650 patients who underwent curative resection for gastric cancer at Kanagawa Cancer Center between July 2009 and July 2013. They were divided into a low-D-dimer group (LD group) and high-D-dimer group (HD group) according to the median D-dimer level on postoperative day (POD) 7. The risk factors for overall survival (OS) and relapse-free survival (RFS) were identified | ||
| 520 | |a RESULTS: Of the 448 enrolled patients, 218 were classified into the LD group and 230 into the HD group. The 5-year OS rates after surgery were 90.8% and 81.3% in the LD and HD groups, respectively (p < 0.001). The 5-year RFS rates after surgery were 89.9% and 76.1% in the LD and HD groups, respectively (p < 0.001). A high D-dimer level on POD 7 (≥ 4.9 μg/ml) was identified as an independent predictive factor for both the OS (hazard ratio [HR] 1.955, 95% confidence interval [CI] 1.158-3.303, p = 0.012) and RFS (HR 2.182, 95% CI 1.327-3.589, p = 0.002). Furthermore, hematological recurrence was significantly more frequent in the HD group than in the LD group (p = 0.014) | ||
| 520 | |a CONCLUSION: A high D-dimer level on POD 7 may predict tumor recurrence and the long-term survival in patients who undergo gastrectomy for locally advanced gastric cancer. Patients with an elevated postoperative D-dimer level need careful observation and diagnostic imaging to timely detect tumor recurrence | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a D-dimer | |
| 650 | 4 | |a Gastrectomy | |
| 650 | 4 | |a Gastric cancer | |
| 650 | 7 | |a Biomarkers, Tumor |2 NLM | |
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| 700 | 1 | |a Hayashi, Tsutomu |e verfasserin |4 aut | |
| 700 | 1 | |a Nakazono, Masato |e verfasserin |4 aut | |
| 700 | 1 | |a Nagasawa, Shinsuke |e verfasserin |4 aut | |
| 700 | 1 | |a Shimoda, Yota |e verfasserin |4 aut | |
| 700 | 1 | |a Kumazu, Yuta |e verfasserin |4 aut | |
| 700 | 1 | |a Numata, Masakatsu |e verfasserin |4 aut | |
| 700 | 1 | |a Yamada, Takanobu |e verfasserin |4 aut | |
| 700 | 1 | |a Tamagawa, Hiroshi |e verfasserin |4 aut | |
| 700 | 1 | |a Shiozawa, Manabu |e verfasserin |4 aut | |
| 700 | 1 | |a Morinaga, Soichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Yukawa, Norio |e verfasserin |4 aut | |
| 700 | 1 | |a Rino, Yasushi |e verfasserin |4 aut | |
| 700 | 1 | |a Masuda, Munetaka |e verfasserin |4 aut | |
| 700 | 1 | |a Ogata, Takashi |e verfasserin |4 aut | |
| 700 | 1 | |a Oshima, Takashi |e verfasserin |4 aut | |
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