1547P - D-dimer lacks value as a screening tool for venous thrombosis but exhibits prognostic power in advanced cancer patients

Abstract

Aim

The incidence of venous thromboembolism (VTE) in advanced cancer patients is high. Analysis of D-dimer concentration serves as a screening test for VTE due to its low cost and high sensitivity, although D-dimer is frequently elevated in response to other causes, such as infection or malignancy. This study aimed to evaluate the role of D-dimer in advanced cancer patients.

Methods

We retrospectively reviewed medical records of patients from July 2012 to October 2013. Incurable cancer patients exhibiting characteristics described in Well's prediction model underwent a D-dimer test at admission.

Results

Among 343 incurable cancer patients, 142 patients received a Well's score ≥2 at admission. Only 4 patients (2.8%) had normal D-dimer levels (<0.5 &mgr;g/mL), and the majority (n = 115, 81.0%) exhibited levels >2.0 &mgr;g/mL. Radiologic workups were performed for 20 patients, because VTE diagnosis would not be beneficial to patients facing imminent death. These workups confirmed VTE in 8 patients (40%). The survival time was significantly differed according to D-dimer levels with a median of 48 days (95% CI, 25.9-70.1) when D-dimer levels were <2 &mgr;g/mL and 19 days (95% CI, 13.7-24.3) days when D-dimer levels were higher (Log-rank, p < 0.001). D-dimer levels were negatively correlated with survival according to Spearman's rank correlation analysis (coefficient -0.335, p < 0.001).

Conclusions

In advanced cancer patients, D-dimer concentrations may lack VTE screening power as patients without VTE also exhibited high levels of D-dimer; however, these values did exhibit prognostic power in these patients.

Disclosure

All authors have declared no conflicts of interest.