d-dimer increase: an unfavorable factor for patients with primary liver cancer treated with TACE

• Published in: Cancer chemotherapy and pharmacology Vol. 83; no. 4; pp. 797 - 802
• Main Authors: Chen, Xujiao, Chang, Zhihui, Liu, Zhaoyu
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2019; Springer Nature B.V
• Subjects: Aged; Cancer Research; Chemoembolization, Therapeutic - methods; Disease Progression; Disease-Free Survival; Female; Fibrin Fibrinogen Degradation Products - metabolism; Humans; Liver cancer; Liver Neoplasms - pathology; Liver Neoplasms - therapy; Male; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Pharmacology/Toxicology; Prognosis; Retrospective Studies; Statistical analysis; Survival; Treatment Outcome; Efficacy; Primary liver cancer; Prognosis; Transcatheter arterial chemoembolization; dimer; D-dimer
• ISSN: 0344-5704; 1432-0843; 1432-0843
• DOI: 10.1007/s00280-019-03778-6

Purpose To explore the clinical significance of plasma d -dimer increase for transcatheter arterial chemoembolization (TACE) in patients with primary liver cancer (PLC). Methods The clinical data of 80 PLC patients who underwent TACE in our hospital from January 2015 to January 2017 were collected, including the plasma d -dimer level 1 week before TACE (D0), d -dimer level 1 month after TACE (D1) and d -dimer level when the disease begins to progress (D2). 1 Month after TACE, these patients were divided into two groups according to the mRecist criteria: disease-controlled group (CR + PR + SD) and disease-progressing group (PD). In all subjects, progression-free survival (PFS) was recorded. D0 and D1 were compared between the two groups by the rank sum test; and the relation between d -dimer level and PFS was assessed by the Kaplan–Meier test and Breslow test. Results In the disease-controlled group, there was no significant difference between D0 and D1 ( P  > 0.05); in the disease-progressing group, D1 was significantly higher than D0 ( P  < 0.05) and the D1 is higher than that in disease-controlled group. In the patients with a negative D1 or D2, PFS was longer than those with a positive level (both P  < 0.05), but such difference was not statistically significant in D0 ( P  > 0.05). In the patients with a d -dimer level increase after TACE (group 3), PFS was shorter than that in those with a d -dimer level decrease after TACE (Group 1) and that in those with a relatively stable d -dimer level before and after TACE (Group 2) ( P  < 0.05); survival in Group 1 was slightly but not significantly longer than that in Group 2 ( P  > 0.05). Conclusion The change in plasma d -dimer level can be used as a biological index to assess the efficacy of TACE and prognosis for PLC patients, and thus, a positive d -dimer level or d -dimer increase after TACE is an unfavorable factor.