D-dimer for assessment of treatment response, and survival to drug-eluting beads transarterial chemoembolization in hepatocellular carcinoma - 31/03/23
, Honglu Li, Liang Cai, Long Cheng, Wenpeng Zhao, Xihong Shao, Hongliu Du, Zhenying Diao, Changqing LiHighlights |
• | Detection of D-dimer in hepatocellular carcinoma patients before and after DEB-TACE. |
• | Elevated D-dimer level was related to tumor burden and poor liver function. |
• | High levels of D-dimer estimated lower complete response to DEB-TACE therapy. |
• | High levels of D-dimer could forecast shorter overall survival to some degree. |
• | The D-dimer level was increased during DEB-TACE therapy. |
Abstract |
Background |
D-dimer exhibits a certain prognostic value in hepatocellular carcinoma (HCC) patients who underwent hepatectomy and microwave ablation, while its value in estimating the clinical benefit of drug-eluting beads transarterial chemoembolization (DEB-TACE) remains unclear. Hence, this study aimed to investigate the correlation of D-dimer with tumor features, response and survival to DEB-TACE in HCC patients.
Methods |
Fifty-one HCC patients treated with DEB-TACE were recruited. Their serum samples at baseline and after DEB-TACE were collected and proposed for D-dimer detection by the immunoturbidimetry method.
Results |
Elevated D-dimer levels were related to a higher Child‒Pugh stage (P = 0.013), tumor nodule number (P = 0.031), largest tumor size (P = 0.004), and portal vein invasion (P = 0.050) in HCC patients. Then, patients were classified by the median value of D-dimer, and it was observed that patients with D-dimer >0.7 mg/L achieved a lower complete response rate (12.0% vs. 46.2%, P = 0.007) but a similar objective response rate (84.0% vs. 84.6%, P = 1.000) compared to those with D-dimer ≤0.7 mg/L. The Kaplan‒Meier curve showed that D-dimer >0.7 mg/L (vs. ≤0.7 mg/L) was related to shorter overall survival (OS) (P = 0.013). Further univariate Cox regression analyses showed that D-dimer >0.7 mg/L (vs. ≤0.7 mg/L) was related to unfavorable OS [hazard ratio (HR): 5.524, 95% confidence interval (CI): 1.209–25.229, P = 0.027], but it failed to independently estimate OS (HR: 10.303, 95%CI: 0.640–165.831, P = 0.100) in multivariate Cox regression analyses. Moreover, D-dimer was elevated during DEB-TACE therapy (P<0.001).
Conclusion |
D-dimer may be helpful for monitoring prognosis to DEB-TACE therapy in HCC, while further large-scale-study validation is warranted.
Le texte complet de cet article est disponible en PDF.Keywords : Hepatocellular carcinoma, Drug-eluting bead transarterial chemoembolization, D-dimer, Treatment response, Survival
Abbreviations : Hepatocellular carcinoma, Drug-eluting beads transarterial chemoembolization
Plan
Vol 47 - N° 4
Article 102096- avril 2023 Retour au numéro
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