The prognostic value of D-dimer levels in metastatic osteosarcoma patients treated with second-line chemotherapy
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Yujing Huang1,*, Bangjian Liu2,*, Yuanjue Sun1, Jianjun Zhang1, Yang Yao1, Aina He1
1Department of Oncology, Affiliated Sixth People’s Hospital, Shanghai Jiaotong University, 200233 Shanghai, People’s Republic of China
2Department of Neurology, Affiliated Sixth People’s Hospital, Shanghai Jiaotong University, 200233 Shanghai, People’s Republic of China
*These authors have contributed equally to this work
Aina He, email: [email protected]
Yang Yao, email: [email protected]
Keywords: D-dimer, osteosarcoma, chemotherapy response, prognosis, second-line chemotherapy
Received: March 15, 2016 Accepted: August 09, 2016 Published: August 24, 2016
We performed a retrospective analysis of 32 metastatic osteosarcoma cases to examine the prognostic value of the plasma D-dimer level. We assessed the D-dimer level before second-line chemotherapy (D1) and the D-dimer level after two cycles of second-line chemotherapy (D2). The change in D-dimer level (ΔD) was defined as D2 minus D1. The overall survival (OS) of patients with a high D1 was significantly shorter than those with a low D1 (median OS, 4.7 vs. 16.2 months, P=0.001). Similar results were observed for the D2 (median OS, 4.7 vs. 8.6 months, P=0.033). Multivariable analysis demonstrated that a high D1 (hazard ratio, 3.375; 95% confidence interval, 1.133–10.053; P=0.029) was an unfavorable independent prognostic factor. The mean D2 of 11 patients with stable disease decreased by 0.69 mg/mL compared to the D1 (P = 0.016). The mean D2 increased by 1.47 mg/mL compared to the D1 in 21 patients with progressive disease (P = 0.004). The data suggest that D-dimer may serve as a prognostic biomarker for metastatic osteosarcoma patients treated with second-line chemotherapy.
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