Abstract
Explain the important role of plasma D-dimer in cancers. Plasma D-dimer is increased in various tumors. However, the predictive value of plasma D-dimer is unclear. This study is aimed to evaluate the prognostic value of the D-dimer level in patients managed with intensity-modulated radiation for endometrial cancer. The D-dimer levels of forty patients with endometrial cancer were assessed before (D1) and after (D2) intensity-modulated radiation therapy (IMRT), respectively. The D-dimer level changes (ΔD) were defined as D2 minus D1. Cox regression and log-rank tests were used to evaluate the D-dimer levels in relation to progression free survival (PFS) and overall survival (OS). The OS and PFS of patients with a low D1 were significantly longer than those with a high D1 (P< 0.001, P< 0.001). We saw the similar correlation between D2, PFS and OS (P< 0.001, P< 0.001). Multivariate survival analyses showed that D-dimer was independently associated with OS and PFS in patients with endometrial cancer. The ΔD level was not related to the OS and PFS in endometrial cancer patients. The levels of D-dimer may be considered as an important predictor of PFS and OS in endometrial cancer patients treated with IMRT.
Highlights
Endometrial cancer is a common gynaecological malignancies [1]
We found that International Federation of Gynecology and Obstetrics (FIGO) stage (P< 0.001, P< 0.001), histologic grade (P= 0.001, P< 0.001), depth of myometrial invasion (MI) (P< 0.001, P< 0.001), lymph node metastasis (P= 0.001, P< 0.001), D1 (P< 0.001, P
D-dimer serves as an indicator of fibrinolytic pathway activation, which is related to unfavorable prognosis in several cancers [7,8,9,10, 13, 14]
Summary
Endometrial cancer is a common gynaecological malignancies [1]. Hysterectomy is the first choice of treatment for endometrial cancer, postoperative pelvic radiotherapy and intensity-modulated radiation therapy (IMRT) is becoming popular and improve the clinical outcome [2]. Development of simple and accurate prediction makers for the prognosis of endometrial cancer patients treated with IMRT after hysterectomy. Several studies report that the level of D-dimer is increased in breast [7], gastric [8], colorectal [9], lung [10], and nasopharyngeal carcinomas [11], and is correlated with a poor prognosis and decreased response to treatment. The relation of D-dimer levels to the survival of patients with endometrial cancer has not been reported
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