D-dimer is a marker of response to chemotherapy in patients with metastatic colorectal cancer

Purpose: D-dimer, LDH and tumor markers are usually overexpressed in colorectal carcinomas (CRC). Our purpose was to assess the prognostic role of D-dimer, lactate dehydrogenase (LDH), CEA, CA19-9 and CA72-4 in patients with metastatic CRC treated with XELOX chemotherapy. Methods: Thirty-eight CRC patients who had evidence of distant metastasis were enrolled in the study and blood samples were taken before chemotherapy for estimation of the tumor markers CEA, CA19-9 and CA72-4, and for D-dimer and LDH. Patients were randomized into 3 groups: those with partial response (PR), stable disease (SD), and progressive disease (PD) according to their clinical and radiologic evaluation after 3 cycles of XELOX chemotherapy. All parameters were reevaluated after the 3rd cycle of chemotherapy. Results: Eighteen patients (47.3%) achieved PR, 10 (26.3%) SD, and 10(26.3%) showed PD. After 3 cycles of XELOX CEA (20.55 vs 11.97 ng/ml; p=0.002), LDH (357.50 vs 214.0 U/lt; p=0.001) and D-dimer (1.56 vs 1.17 mu gFEU/ml; p=0.022) levels were significantly decreased in the PR group. D-dimer levels were also notably decreased (1.36 vs 0.77 mu gFEU/ml; p=0.021) in the SD group. In the PD group a considerable increase was seen in CA 19-9 (119.5 vs 243.09 U/ml; p=0.025), CA 72-4 (5.18 vs 25.8 U/ml; p=0.036) and D-dimer levels (1.77 vs 1.88 mu gFEU/ml; p=0.012). Conclusion: This study demonstrated that D-dimer, LDH and tumor markers can be helpful in determining CRC prognosis in patients with metastatic disease. D-dimer, LDH and tumor markers provided unique prognostic information in advanced CRC patients.