Predictive value of indicator of CA125 combined with D-dimer (ICD) for lymph node metastasis in patients with ovarian cancer: A two center cohort study

Background: The clinical serum markers CA125 and D-dimer have been reported to predict lymph node metastasis(LNM) in several malignant tumors, but the reports in ovarian cancer(OC) are still absent. The purpose of this study was to explore the value of indicator CA125 combined with D-dimer (ICD) in predicting LNM in patients with OC. Methods: A total of 447 patients diagnosed with OC from January 2008 to June 2019 were included in this retrospective study as the training set. A total of 284 patients were included in the validation set. The optimal cut-off critical value of ICD was evaluated by the receiver operating characteristic curve (ROC), and the maximum Youden index (sensitivity + specificity-1). Univariate and multivariate analysis were used to evaluate ICD as a predictor of LNM in OC. Results: According to ROC curve, area under curve (AUC) of ICD (AUC=0.706, p<0.001) was significantly larger than that of CA125 (AUC=0.671, p<0.001) and D-dimer (AUC=0.562, p=0.022) alone. Multivariate analysis showed that ICD (HR 2.651, 95% CI 1.273-5.520, p=0.009) was an independent predictor of LNM and overall survival (OS) in OC. It has also been verified in another medical center. Conclusion: ICD is an independent predictor of LNM in ovarian cancers, which is helpful for clinicians to draw up individual treatment plans.