D‑dimer as a more effective marker for detecting thrombosis in patients with ovarian clear cell carcinoma compared with high‑grade serous carcinoma

The present retrospective cohort study aimed to examine the effectiveness of D-dimer in detecting cancer-associated thromboembolism (CAT) in clear cell carcinoma (CCC) compared with that in high-grade serous carcinoma (HGSC) to develop an effective screening method. Patients diagnosed with CCC or HGSC who underwent primary surgery at National Defense Medical College Hospital (Tokorozawa, Japan) between January 2009 and December 2023 were included in the present study, and their clinical records were analyzed. Patients with a history of thrombosis and anticoagulation and those with acute infection at the initial visit were excluded. In the CCC and HGSC groups, 20 out of 79 patients (25.3%) and 15 out of 123 patients (12.2%) developed CAT, respectively, indicating that CAT was more common in patients with CCC (P=0.022). D-dimer was a significantly better predictor in CCC [area under the curve (AUC), 0.92] than in HGSC (AUC, 0.75). Multivariate analysis demonstrated that the International Federation of Gynecology and Obstetrics (FIGO) stage was an independent risk factor for CAT (odds ratio, 3.28; 95% CI, 1.04-10.3; P=0.042) in the CCC group. For CAT detection, combining D-dimer with FIGO stage further improved the predictive accuracy in early-stage CCC (AUC, 0.97). These results may be useful for CAT screening in clinical practice.