International Journal of Clinical Oncology

, Volume 23, Issue 4, pp 689–697 | Cite as

D-dimer predicts postoperative recurrence and prognosis in patients with liver metastasis of colorectal cancer

  • Akira Watanabe
  • Kenichiro Araki
  • Norihumi Harimoto
  • Norio Kubo
  • Takamichi Igarashi
  • Norihiro Ishii
  • Takahiro Yamanaka
  • Kei Hagiwara
  • Hiroyuki Kuwano
  • Ken Shirabe
Original Article



Colorectal cancer is common, and its incidence is increasing throughout the world. The liver is a major metastatic site, and colorectal liver metastasis (CRLM) has a poor prognosis. Although liver resection is the most effective therapy for CRLM, postoperative recurrence is common. Thus, prognostic markers for CRLM are greatly needed. D-dimer, a fibrin cleavage product, has been shown to be related to colorectal tumor progression, and is also associated with malignant progression and recurrence in various cancers. Therefore, we evaluated the value of D-dimer in predicting the prognosis in CRLM.


We retrospectively evaluated 90 cases of resected CRLM to determine the correlation between D-dimer and patient survival. The cut-off value for D-dimer levels was determined using receiver operating characteristic curve analysis.


Significant differences occurred in the recurrence group with higher D-dimer levels (P = 0.00736*), while the optimal cut-off value was 0.6 µg/mL. High D-dimer levels (≥ 0.6 µg/mL) were associated with poor recurrence-free survival (RFS; P = 0.0000841*) and cancer-specific survival (CSS; P = 0.00615*). In the multivariate analysis, D-dimer correlated with CRLM prognosis and independently predicted RFS (P = 0.0179*).


High D-dimer levels were associated with poor RFS and CSS. D-dimer was an independent prognostic factor of RFS. Therefore, D-dimer may help predict recurrence and prognosis in patients with CRLM.


D-dimer Colorectal cancer Liver metastasis 



Colorectal liver metastasis


Carcinoembryonic antigen


Receiver operating characteristic


Venous thrombosis


Neutrophil/lymphocyte ratio


Modified Glasgow Prognostic Score


Recurrence-free survival


Cancer-specific survival


Circulating tumor cells



We thank Ms. Yukie Saito, Ms. Tomoko Yano, Ms. Tomoko Ubukata, and Ms. Yuki Saka for their excellent assistance.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest.

Supplementary material

10147_2018_1271_MOESM1_ESM.pdf (144 kb)
Supplementary material 1 (PDF 143 kb)


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Copyright information

© Japan Society of Clinical Oncology 2018

Authors and Affiliations

  • Akira Watanabe
    • 1
  • Kenichiro Araki
    • 1
  • Norihumi Harimoto
    • 1
  • Norio Kubo
    • 1
  • Takamichi Igarashi
    • 1
  • Norihiro Ishii
    • 1
  • Takahiro Yamanaka
    • 1
  • Kei Hagiwara
    • 1
  • Hiroyuki Kuwano
    • 2
  • Ken Shirabe
    • 1
  1. 1.Department of Hepatobiliary and Pancreatic SurgeryGunma University Graduate School of MedicineMaebashiJapan
  2. 2.Department of General Surgical ScienceGunma University Graduate School of MedicineMaebashiJapan

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