Correlation of D-dimer Value and Venous Thromboembolism (VTE) in Patients with Advanced Non-Small Cell Lung Cancer (NSCLC)

  • #TS/SUP 01-O-5
  • Thoracic Surgery/Suppurative Lung Disease/Complications/ Other/Lung Transplantation
  • Oral

Correlation of D-dimer Value and Venous Thromboembolism (VTE) in Patients with Advanced Non-Small Cell Lung Cancer (NSCLC)

Dimitrios A. Lioumpas 1, Ilias Samiotis 2, Charalampos Zisis 2, Despoina Mylonaki 1, Kostantinos Bouboulis 1, Ioannis Stamatatos 1, Stylianos Zaragkas 1, Nikolaos Tzatzadakis 1


Date, time and location: 2018.05.25 10:30, Press Hall, 2F


BACKROUND: Acute thromboembolic disease is presented as a frequent complication of lung cancer patients. Activation of the exogenous coagulation system and fibrinolytic cataract within the tumor is associated with advanced disease stage, poor response to treatment and negative prognostic outcome in these patients. The study sought to analyze a possible correlation of elevated levels D-dimers and the likelihood of VTE in NSCLC patients.

METHODS:We retrospectively reviewed the medical records, between 2010 – 2015, on 182 newly diagnosed patients with advanced stage III (39%) and IV (61%) NSCLC. D-dimer measurements were conducted using the immunopolymeric method, with positive cut-off values ​​of > 0.5mg / dl. We evaluated thecalculated probabilityand the odds of elevated D-dimer levels to be associated with a clinical VTE event in the first year of diagnosis, based on Wells score. Patients receiving any type of anticoagulation therapy were excluded from the study.

RESULTS: The overall incidence of VTE was 7.6% and significantly higher in patients with adenocarcinoma (71%). The most frequent manifestation, was deep vein thrombosis of lower limps (n = 9), pulmonary embolism (n = 3), and thrombosis of the upper right limp (n = 1) and of right subclinical vein (n = 1). No correlation of elevated D-dimer values ​​and VTE manifestation was observed (p = 0.064). However, there was an increased probability of VTE in patients with dimer values > 9mg / dl (odds = 1.7)

CONCLUSIONS:High D-dimer values ​​have been traditionally associated with an increased likelihood of VTE events on oncological patients. Our study recognises that elevated D-dimer values are not directly associated with VTE events in patients with advanced stages of NSCLC. However, we anticipate that on population with D-dimer values of > 9 mg / dl, a more  aggressive coverage with low molecular weight heparin (LMWH) may be required.

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