Erschienen in:
21.07.2016 | Hepatobiliary Tumors
A Novel Clinical Factor, D-Dimer Platelet Multiplication, May Predict Postoperative Recurrence and Prognosis for Patients with Cholangiocarcinoma
verfasst von:
Akira Watanabe, MD, PhD, Kenichiro Araki, MD, PhD, Keitarou Hirai, MD, PhD, Norio Kubo, MD, PhD, Takamichi Igarashi, MD, Mariko Tsukagoshi, MD, Norihiro Ishii, Kouki Hoshino, MD, Hiroyuki Kuwano, MD, PhD, Ken Shirabe, MD, PhD
Erschienen in:
Annals of Surgical Oncology
|
Sonderheft 5/2016
Einloggen, um Zugang zu erhalten
Abstract
Background
Patients with cholangiocarcinoma (CC) have a poor prognosis, and their postoperative survival depends on cancer progression and recurrence. Thus, prognostic markers are needed. The fibrin cleavage product, D-dimer, is associated with malignant progression and recurrence in various cancers, and platelets also are related to tumor progression. This study therefore evaluated a new prognostic factor, D-dimer platelet multiplication (PDM), for predicting prognosis in cases of CC.
Methods
This study retrospectively evaluated 55 cases to determine the correlations of D-dimer, platelet, and PDM levels with patient survival. The cutoff values for D-dimer, platelets, and PDM levels were determined using receiver operating characteristic curve analyses.
Results
The recurrence group exhibited significantly higher D-dimer (P = 0.00075) and PDM (P = 0.0000683) levels and a trend toward higher platelet levels (P = 0.117). The optimal cutoff values were 1.3 µg/mL for D-dimer levels, 245 × 104/µL for platelet levels, and 158.2 × 104 µg/mL × µL for PDM levels. Poor recurrence-free survival was associated with high D-dimer levels (P = 0.0428), high platelet levels (P = 0.0498), and high PDM levels (P = 0.00511). Poor cancer-specific survival was associated with high platelet levels (P = 0.0156) and high PDM levels (P = 0.0156). In the multivariate analysis, PDM had the greatest correlation with CC prognosis and independently predicted recurrence (P = 0.00649).
Conclusion
High D-dimer, platelet, and PDM levels were associated with poor recurrence-free and cancer-specific survivals, with PDM exhibiting the greatest correlation with prognosis. Therefore, PDM may help to predict recurrence and prognosis for patients with CC.