Affiliation:
1. Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer Department of Pancreatic Cancer, , Hexi District, Tianjin , China
2. Inner Mongolia Autonomous Region People's Hospital Department of Hepatobiliary-Pancreatic-Splenic Surgery, , Hohhot , China
Abstract
Abstract
Objective
In this study, the relationship between preoperative plasma D-dimer level and overall survival and recurrence free survival were evaluated in patients with curative resection of pancreatic ductal adenocarcinoma.
Methods
Preoperative plasma D-dimer level of 573 patients with pancreatic ductal adenocarcinoma were collected. The univariate and multivariate Cox hazard models were used to identify independent variables associated with overall survival and recurrence free survival in this study. The Kaplan–Meier method was used to evaluate overall survival and recurrence free survival, and the differences between survival curves were analyzed using the Log-rank test. Continuous variables were presented as $\overline{x}\pm s$, parametric analysis was performed using t-test. Categorical variables were analyzed by means of the chi-square or Fisher’s exact test.
Results
Based on the analysis for the whole study, the results showed that patients in the elevated plasma D-dimer levels had a tendency to have an elder mean age (58.69 ± 8.32 years vs. 63.05 ± 8.44 years, P < 0.001), larger tumour size ≥4 cm (P = 0.006), advanced T stage (P = 0.024), N stage (P = 0.041), Tumor, Node and Metastasis (TNM) stage (P = 0.029) and postoperative complications (P = 0.042) was more likely occurred. Besides, according to the results of Cox multivariate analysis, elevated preoperative plasma D-dimer level was an independent prognostic factor not only for overall survival (Hazard Ratio (HR):1.430, 95% Confidence Interval (CI) (1.163–1.759), P = 0.001) but also for recurrence free survival (HR:1.236, 95% CI (1.018–1.500), P = 0.032).
Conclusion
In our study, the elevated preoperative plasma D-dimer level may act as an independent prognostic factor for overall survival and recurrence free survival in patients with pancreatic ductal adenocarcinoma after curative resection. Pancreatic ductal adenocarcinoma patients with elevated preoperative plasma D-dimer level had a worse prognosis than those with normal plasma D-dimer level; and the elevated preoperative plasma D-dimer level may imply heavy tumour burden and provide supplementary information regarding disease status.
Publisher
Oxford University Press (OUP)
Subject
Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology,General Medicine
Reference51 articles.
1. Cancer statistics, 2021;Siegel;CA Cancer J Clin,2021
2. Cancer statistics in China and United States, 2022: profiles, trends, and determinants;Xia;Chin Med J (Engl),2022
3. Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020;Cao;Chin Med J (Engl),2021
4. Patterns, timing, and predictors of recurrence following Pancreatectomy for pancreatic ductal adenocarcinoma;Groot;Ann Surg,2018
5. Surveillance, Epidemiology, and End Results Program