Relationship between coagulation and prognosis of gastric cancer: a systematic review and meta-analysis

Background The hypercoagulable state of cancer patients is associated with their high mortality rate. Coagulation indicators may have an important role in the prognosis of gastric cancer patients and deserve to be explored in various aspects. Objective We conducted a meta-analysis to explore the correlation between coagulation and prognosis of gastric cancer. Methods A comprehensive systematic search was conducted in PubMed, Embase, Web of Science databases and the Cochrane Library up to February 16, 2024. Literature screening and data extraction were performed by two independent reviewers. The processed data we pooled using either a random-effects model or a fixed-effects model and finally described overall survival with a risk ratio (HR) and predicted the likelihood of different clinicopathological events with a dominance ratio (OR). Results A total of 64 studies were screened for inclusion in the data analysis. Performing meta-analysis of three indicators we derived that the risk of D-dimer, fibrinogen and platelets were: HR = 1.85 (95% CI: 1.59-2.15, N=15), HR = 1.77 (95% CI: 1.57-1.99, N=28), HR = 1.16 (95%CI: 1.12-1.21, N=29). In addition to this, all three were associated with advanced clinicopathological stage (D-D: OR=2.25, FIB: OR=2.07, PLT: OR=1.84), T stage (D-D: OR=2.30, FIB: OR=2.38, PLT: OR=2.22) and lymph node metastasis (D-D: OR=1.79, FIB: OR=1.70, PLT: OR=1.51). Conclusion Overall, the findings suggest that the three indicators, D-dimer, fibrinogen and platelet count, have significant predictive value for the prognosis of gastric cancer. And they were associated with advanced clinicopathological stage and high risk of lymph node metastasis.