The predictive value of D-dimer measurement for cancer in patients with deep vein thrombosis

• Published in: Haematologica (Roma) Vol. 90; no. 2; pp. 214 - 219
• Main Authors: Schutgens, RE, Beckers, MM, Haas, FJ, Biesma, DH
• Format: Journal Article
• Language: English
• Published: Pavia Haematologica 01-02-2005
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anticoagulants - pharmacology; Biological and medical sciences; Female; Fibrin Fibrinogen Degradation Products - biosynthesis; Hematologic and hematopoietic diseases; Humans; Male; Medical sciences; Middle Aged; Neoplasms - blood; Neoplasms - complications; Neoplasms - diagnosis; Predictive Value of Tests; Prevalence; Venous Thrombosis - blood; Venous Thrombosis - complications; Venous Thrombosis - diagnosis; Vascular disease; Human; Hematology; Deep vein thrombosis; Predictive value; D-dimer; Cardiovascular disease; cancer; Malignant tumor; D dimer; Venous disease
• ISSN: 0390-6078; 1592-8721

Department of Hematology, University Hospital Utrecht, the Netherlands. [e-mail]
BACKGROUND AND OBJECTIVES: Venous thromboembolism can be related to malignancy, but routine screening for cancer in patients with deep vein thrombosis (DVT) is not a recommended practice. The aim of this study was to evaluate the value of D-dimer concentration in predicting cancer in patients with DVT. DESIGN AND METHODS: D-dimer levels were measured in outpatients presenting with DVT. In a proportion of patients, D-dimer levels were measured daily for 4 days. The occurrence of malignancy was documented. RESULTS: Patients were followed for a median of 34 months. Fifty (23%) of 218 patients with thrombosis had cancer in the study period including 14 who developed cancer during the follow-up. High initial D-dimer levels (levels > 4000 mg/L) were associated with more cancer during follow-up than were lower D-dimer levels: 13% versus 4% (p=0.048). High D-dimer levels after 4 days of treatment were associated with a 15% prevalence of cancer whereas the prevalence in patients with lower D-dimer levels was 5% (p=0.1). The total cancer prevalence (including cancer diagnosed before thrombosis) in patients with initial D-dimer levels