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High Pretreatment Plasma D-dimer Levels Are Associated With Poor Prognosis in Patients With Ovarian Cancer Independently of Venous Thromboembolism and Tumor Extension
  1. Manabu Sakurai, MD,
  2. Toyomi Satoh, MD, PhD,
  3. Koji Matsumoto, MD, PhD,
  4. Hiroo Michikami, MD,
  5. Yuko Nakamura, MD,
  6. Sari Nakao, MD, PhD,
  7. Hiroyuki Ochi, MD, PhD,
  8. Mamiko Onuki, MD, PhD,
  9. Takeo Minaguchi, MD, PhD and
  10. Hiroyuki Yoshikawa, MD, PhD
  1. Departments of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
  1. Address correspondence and reprint requests to Manabu Sakurai, MD, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki 305-8575, Japan. E-mail: m-sakurai{at}


Objective Elevated plasma D-dimer (DD) is associated with decreased survival among patients with breast, lung, and colon cancers. The present study clarifies the prognostic significance of pretreatment plasma DD levels in patients with epithelial ovarian cancer (EOC).

Methods We investigated pretreatment DD levels and other variables for overall survival using univariate and multivariate analyses in 134 consecutive patients with EOC stages II to IV who were initially treated between November 2004 and December 2010.

Results The median follow-up period was 53 (7–106) months. Univariate analysis significantly associated elevated pretreatment DD (≥2.0 μg/mL) levels to poor 5-year overall survival rates irrespective of previously treated venous thromboembolism (72.2% vs 52.6%, P = 0.039). Cancer antigen 125 levels of 200 U/mL or higher (P = 0.011), distant metastases (P = 0.0004), residual tumors (P < 0.0001), and International Federation of Gynecology and Obstetrics stage III/IV (P = 0.0033) were also poor prognostic factors. Multivariate analysis independently associated DD levels of 2.0 μg/mL or higher (P = 0.041), distant metastases (P = 0.013), and residual tumors (P < 0.0001) with poor overall survival.

Conclusions High pretreatment DD levels are associated with poor overall survival in patients with EOC independently of venous thromboembolism and tumor extension and might comprise a promising prognostic biomarker for patients with EOC.

  • Plasma D-dimer
  • Epithelial ovarian cancer
  • Prognosis

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  • The authors declare no conflicts of interest.

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