Park K, Ryoo BY, Ryu MH, Park SR, Kang MJ, Kim JH, Han S, Kang YK. Incidence of venous thromboembolism and the role of D-dimer as predictive marker in patients with advanced gastric cancer receiving chemotherapy: A prospective study. World J Gastrointest Oncol 2017; 9(4): 176-183 [PMID: 28451065 DOI: 10.4251/wjgo.v9.i4.176]
Corresponding Author of This Article
Baek-Yeol Ryoo, MD, PhD, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-gu, Seoul 05505, South Korea. ryooby@amc.seoul.kr
Research Domain of This Article
Allergy
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Apr 15, 2017; 9(4): 176-183 Published online Apr 15, 2017. doi: 10.4251/wjgo.v9.i4.176
Incidence of venous thromboembolism and the role of D-dimer as predictive marker in patients with advanced gastric cancer receiving chemotherapy: A prospective study
Kwonoh Park, Baek-Yeol Ryoo, Min-Hee Ryu, Sook Ryun Park, Myoung Joo Kang, Jeong Hye Kim, Seungbong Han, Yoon-Koo Kang
Kwonoh Park, Medical Oncology and Hematology, Department of Internal medicine, Pusan National University Yangsan Hospital, Gyeongsangnam-do 50612, South Korea
Kwonoh Park, Baek-Yeol Ryoo, Min-Hee Ryu, Sook Ryun Park, Myoung Joo Kang, Jeong Hye Kim, Yoon-Koo Kang, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
Seungbong Han, Department of Clinical Epidemiology and Biostatics, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
Author contributions: Kang MJ designed the research; Park K and Ryu MH wrote the study; Park SR, Kim JH and Kang YK supported clinical data and clinical advice; Han S contributed to the statistical analysis; Ryoo BY designed the research and supervised the report.
Institutional review board statement: The study was approved by the institutional review board of Asan Medical Center and conducted in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines.
Clinical trial registration statement: The registration identification number is ClinicalTrials.gov identifier (NCT01047618).
Informed consent statement: All participants provided written informed consent before enrollment.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Baek-Yeol Ryoo, MD, PhD, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-gu, Seoul 05505, South Korea. ryooby@amc.seoul.kr
Telephone: +82-2-30103211 Fax: +82-2-30108772
Received: December 5, 2016 Peer-review started: December 6, 2016 First decision: January 7, 2017 Revised: January 22, 2017 Accepted: February 28, 2017 Article in press: February 28, 2017 Published online: April 15, 2017 Processing time: 125 Days and 19.7 Hours
Abstract
AIM
To investigated the incidence and risk factors of venous thromboembolism (VTE) in patients with advanced gastric cancer (AGC) receiving chemotherapy.
METHODS
All consecutive chemotherapy-naïve patients with AGC who would receive palliative chemotherapy between November 2009 and April 2012 in our hospital were recruited. Their pretreatment clinical and laboratory variables, including D-dimer, were recorded. The frequency of VTE development and survival rates during each chemotherapy cycle and regularly thereafter were assessed.
RESULTS
A total of 241 patients enrolled between November 2009 and April 2012 were analyzed. During a median follow-up duration of 10.8 mo (95%CI: 9.9-11.7), 27 patients developed VTE and the incidence of VTE was 17.5% (95%CI: 10.5-24.0, 12.0 events/100 person-years). The 6-mo and 1-year cumulative incidences were 7.8% (95%CI: 4.2%-11.4%) and 12.4% (95%CI: 7.3-17.2), respectively. Thirteen (48.1%) patients were symptomatic and the other 14 (51.9%) patients were asymptomatic. In multivariate analysis, pretreatment D-dimer level was the only marginally significant risk factor associated with VTE development (hazard ratio = 1.32; 95%CI: 1.00-1.75, P = 0.051).
CONCLUSION
The incidence of VTE is relatively high in patients with AGC receiving chemotherapy, and pretreatment D-dimer level might be a biomarker for risk stratification of VTE.
Core tip: The incidence of venous thromboembolism (VTE) is relatively high in patients with advanced gastric cancer receiving chemotherapy, and pretreatment D-dimer level is a risk factor for VTE. Considering the usefulness of D-dimer as a biomarker given its ease of use and low cost, pretreatment D-dimer might be a risk stratification factor for VTE development and patient selection for thromboprophylaxis.
