P3.16-09 High Preoperative D-Dimer Level Predicts Early Recurrence After Surgery for Non-Small Cell Lung Cancer

Abstract

Carcinoma cells often affect the coagulation and fibrinolysis among cancer patients. Plasma dimerized plasmin fragment D (D-dimer) has been reported as the prognostic marker of various type of malignancies. For non-small cell lung cancer (NSCLC) patients, significance of D-dimer levels still remains unclear. Two hundred and thirty five patients with NSCLC who underwent radical surgery between April 2015 and March 2017 were retrospectively reviewed. We divided two groups including 1) high D-dimer (over 1.0ug/mL) group (hDD group, n=47), and 2) normal D-dimer group (nDD group, n=188). The clinical characteristics, tumor CT findings, pathological findings, and clinical outcomes were analyzed. The mean D-dimer level was 2.49±2.58 among hDD group. The hDD group had the character of 1) male gender, 2) elder patients, 3) larger tumor size (p=0.0011), 4) pure solid appearance (p=0.0203). The hDD group showed worse overall survival (OS), disease free survival (DFS), and disease specific survival (DSS) than nDD group (Figure 1-A, B, C; log-rank test, p<0.0001, =0.0007, =0.0003, retrospectively) and these findings were also observed only for the p-Stage IA cases. Interestingly patients with grand glass attenuation-dominant nodule were not affected by D-dimer level with favor prognosis. Pathology showed more frequent vessel involvement (v+) in hDD group (p=0.033), but there was no significant difference for histology or histological subtypes of adenocarcinoma. The preoperative D-dimer level predicts the postoperative early recurrence and poor prognosis in the patients with NSCLC with pure solid appearance on chest CT.