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. 2019 Aug;7(16):366.
doi: 10.21037/atm.2019.05.35.

Preoperative D-dimer level is an independent prognostic factor for non-small cell lung cancer after surgical resection: a systematic review and meta-analysis

Han-Yu Deng  1 , Xi Zheng  1 , Rui Jiang  1 , Rui-Lan Wang  1 , Jie Zhou  1 , Xiao-Ming Qiu  1
Affiliations

Preoperative D-dimer level is an independent prognostic factor for non-small cell lung cancer after surgical resection: a systematic review and meta-analysis

Han-Yu Deng et al. Ann Transl Med. 2019 Aug.

Abstract

Background: Whether high preoperative D-dimer level has any impact on long-term survival of patients with surgically treated non-small cell lung cancer (NSCLC) remains unclear. Therefore, we conducted the first meta-analysis focusing specifically on prognostic value of high preoperative D-dimer level in NSCLC patients after surgical resection comprehensively.

Methods: We conducted a systematic search for relevant studies in PubMed, Embase, and Web of Science on January 28, 2019. Data for analysis consisted of hazard ratio (HR) with 95% confidence interval (CI) of overall survival (OS) and disease-free survival (DFS) from multivariate analysis and were analyzed by using the STATA 12.0 package.

Results: Finally, we included a total of 6 cohort studies consisting of 1,817 patients with surgically treated NSCLC for analysis. Our meta-analysis found that NSCLC patients with high preoperative D-dimer level had a significantly worse OS (random effects: HR =2.04; 95% CI: 1.30-3.20; P=0.002; I2=67.4%) and DFS (fixed effects: HR =1.98; 95% CI: 1.41-2.78; P<0.001; I2=0.0%) than these with normal preoperative D-dimer level after surgery. However, potential heterogeneity and publication bias was observed during analysis.

Conclusions: High pretreatment level of D-dimer remains to be an independent predictor of poor prognosis in NSCLC patients after surgery. Further well-conducted studies with appropriate adjustments are needed to confirm and update our conclusions.

Keywords: D-dimer; meta-analysis; non-small cell lung cancer (NSCLC); prognosis; surgery.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
A flow chart showing the progress of study evaluation throughout the meta-analysis. SCLC, small cell lung cancer; NSCLC, non-small cell lung cancer.
Figure 2
Figure 2
Forest plots of (A) overall survival, and (B) disease-free survival rate. HR, hazard ratio; CI, confidence interval.
Figure 3
Figure 3
Sensitivity analysis for overall survival. CI, confidence interval.
Figure 4
Figure 4
Funnel plot of the included studies for analysis of overall survival. Begg’s test: P=0.014; Egger’s test: P=0.007.
See this image and copyright information in PMC

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