Prognostic value of plasma D-dimer levels in patients with small-cell lung cancer

Objective: Little data exists with respect to the relationship between the level of plasma D-dimer and prognosis of small cell lung cancer (SCLC). The aim of this study was to investigate whether the levels of plasma D-dimer could be served as a prognostic factor in patients with SCLC. Methods: A total of 393 patients with SCLC were addressed in the present retrospective study. Plasma D-dimer levels were measured by immunoturbidimetric assay. The correlation between plasma D-dimer levels and other clinical features, progression free survival (PFS) and overall survival (OS) was analyzed statistically. Results: The plasma D-dimer levels were significantly correlated with karnofsky performance status (KPS), tumor stage, number of metastatic sites, and treatment response. The PFS and OS of patients with elevated D-dimer levels before chemotherapy were significantly shorter than that of patients with normal D-dimer levels (PFS: 6.2 months versus 9.6 months, P < 0.001; OS: 15.7 months versus 24.4 months, P < 0.001). The patients with D-dimer levels converting from high to normal had better PFS and OS than those with D-dimer levels remaining high after two cycles of chemotherapy. According to multivariate analysis, elevated D-dimer level was confirmed to be an independent prognostic factor for worse survival. Conclusions: Elevated plasma D-dimer level could be served as an independent determinant of poor prognosis in patients with SCLC. (C) 2016 Published by Elsevier Masson SAS.