The Association Of D-dimer Level And Venous Thromboembolism (VTE) In Patients With Metastatic Cancers

BackgroundThere is higher risk of incidence of venous thromboembolism(VTE)among patients with metastatic malignancies.VTE is associated with poorer prognosis in cancer patients.However,clinical strategy to predict VTE occurrence in metastatic cancer patients remains to be improved.ObjectiveTo evaluate the association of pretreatment D-dimer level and VTE occurrence in patients with metastatic cancers.MethodsRetrospectively collected data of 1016 patients with metastatic cancers from Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiaotong University between January 1st,2014 to December 30th,2017.Analyzed pretreatment data including basic clinical characteristics,common blood count,D-dimer,fibrinogen and treatment methods.Reviewed reports of vascular duplex ultrasonography and chest/abdominal enhanced computed tomography since the time of first metastasis to the time of VTE occurrence、December 31th 2018 or death.Identified the association of D-dimer with VTE occurrence.Evaluated risk factors in patients with metastatic cancers that are associated with the occurrence of VTE via univariate analysis and multivariate logistic regression.ResultAmong 1016 patients with metastatic patients,VTE occurred in 109 patients.Among them,105 patients suffered from deep venous thromboembolism(DVT);DVT from lower extremities,upper extremities and the rest parts of body occurred in 81,15 and 9 patients,respectively.There were 6 cases of pulmonary embolism.4 of which were isolated PE while 2 with DVT.High D-dimer level(Z=-7.084,p=0.000)was associated with high VTE occurrence(p<0.05).In multivariate analysis,we identified that KPS score(OR=1.932,p=0.029)、primary gynecologic cancer(OR=2.482,p=0.006)、D-dimer lever>1.785 μg/mL(OR=3.840,p=0.000)and chemotherapy(OR=1.881,p=0.006)were related to higher risk of VTE occurrence(p<0.05).ConclusionsHigh D-dimer level was associated high risk of VTE occurrence.KPS score>primary gynecologic cancer、D-dimer lever>1.785μg/mL and chemotherapy were related to higher risk of occurrence of VTE.