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. 2017 May 16;8(31):51551-51558.
doi: 10.18632/oncotarget.17936. eCollection 2017 Aug 1.

A high plasma D-dimer level predicts poor prognosis in gynecological tumors in East Asia area: a systematic review and meta-analysis

Lei Xu #  1   2 , Fan He #  3 , Hongcai Wang  2 , Bei Gao  4 , Huini Wu  5 , Shuping Zhao  1
Affiliations

A high plasma D-dimer level predicts poor prognosis in gynecological tumors in East Asia area: a systematic review and meta-analysis

Lei Xu et al. Oncotarget. .

Abstract

High pre-treatment plasma D-dimer levels have been reported as a factor associated with a poor prognosis in different types of malignancies, including pancreatic, gastric, colorectal, lung, and nasopharyngeal carcinoma. Here, we performed a meta-analysis to determine the association of plasma D-dimer levels and long term survival in gynecological cancers, including ovarian, cervical and endometrial carcinoma. We searched all eligible publications in PubMed and Web of Science Databases up to August 2016. Primary outcomes, including overall survival (OS), disease-free survival and hazard ratios (HR) of were extracted and analyzed. Heterogeneity and publication bias were also assessed. A total of 7 eligible studies with 1112 cases were included in this study and all included studies are conducted in East Asia area. We found that gynecological cancer patients with high D-dimer demonstrates a much lower 5-year survival rate than those with low D-dimer levels (OR 4.12, 95% CI 3.04-5.58, P<0.00001). No significant heterogeneity is found (I2 = 10 %; P = 0.35). Importantly, pooled analysis showed that high plasma D-dimer levels are predictive of a shorter OS in gynecological cancers (HR 2.09, 95% CI 1.59-2.74). No heterogeneity is observed (I2=5%, P=0.39). Additionally, a subgroup analysis of ovarian cancer is conducted. In conclusion, this meta-analysis showed that a high plasma D-dimer level predicts poor prognosis in gynecological tumors.

Keywords: D-dimer; gynecological tumors; meta-analysis; prognosis.

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Conflict of interest statement

CONFLICTS OF INTEREST The authors have no conflicts of interest to report.

Figures

Figure 1
Figure 1. Flow diagram of search strategy in the meta-analysis
Figure 2
Figure 2. Forest plot of overall survival (OS) rates of high and low plasma D-dimer
(A) Forest plot of 1-year OS rates of high and low plasma D-dimer. (B) Forest plot of 3-year OS rates of high and low plasma D-dimer. (C) Forest plot of 5-year OS rates of high and low plasma D-dimer. C: cervical cancer, O: ovarian cancer, E: endometrial cancer.
Figure 3
Figure 3. Forest plot of hazard ratio for the association of high plasma D-dimer level and OS; C: cervical cancer, O: ovarian cancer, E: endometrial cancer
Figure 4
Figure 4. Begg's funnel plots of publication bias
(A) Meta-analysis of 1 year overall survival rates of high and low plasma D-dimer. (B) Meta-analysis of 3 year overall survival rates of high and low plasma D-dimer. (C) Meta-analysis of 5 year overall survival rates of high and low plasma D-dimer. (D) Meta-analysis of hazard ratio for the association of high plasma D-dimer level and OS.
Figure 5
Figure 5. Subgroup analysis of ovarian cancer
(A) Forest plot of 1 year OS rates of high and low plasma D-dimer. (B) Forest plot of 3-year OS rates of high and low plasma D-dimer. (C) Forest plot of 5-year OS rates of high and low plasma D-dimer. (D) Begg's funnel plots of publication bias of 1-year OS rates of high and low plasma D-dimer. (E) Begg's funnel plots of publication bias of 3-year OS rates of high and low plasma D-dimer. (F) Begg's funnel plots of publication bias of 5-year OS rates of high and low plasma D-dimer.
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66:7–30. - PubMed
    1. Vergote IB, Jimeno A, Joly F, Katsaros D, Coens C, Despierre E, Marth C, Hall M, Steer CB, Colombo N, Lesoin A, Casado A, Reinthaller A, et al. Randomized phase III study of erlotinib versus observation in patients with no evidence of disease progression after first-line platin-based chemotherapy for ovarian carcinoma: a European Organisation for Research and Treatment of Cancer-Gynaecological Cancer Group, and Gynecologic Cancer Intergroup study. J Clin Oncol. 2014;32:320–326. - PubMed
    1. Lyman GH, Khorana AA. Cancer, clots and consensus: new understanding of an old problem. J Clin Oncol. 2009;27:4821–4826. - PMC - PubMed
    1. Adam SS, Key NS, Greenberg CS. D-dimer antigen: current concepts and future prospects. Blood. 2009;113:2878–2887. - PubMed
    1. Ye S, Zhang W, Yang J, Cao D, Huang H, Wu M, Lang J, Shen K. Pattern of Venous Thromboembolism Occurrence in Gynecologic Malignancy: Incidence, Timing, and Distribution a 10-Year Retrospective Single-institutional Study. Medicine (Baltimore) 2015;94:e2316. - PMC - PubMed

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