D-dimer as a Biomarker in Prostate Cancer: a Scoping Review of Current Evidence
Year: 2026
Type: article
Study design: Systematic Review
Abstract: Introduction Prostate cancer is associated with persistent activation of coagulation and fibrinolysis, reflecting the interplay among inflammation, hypercoagulability, and tumor progression. Although D-dimer is a well-established marker of hemostatic activation, its clinical utility as a biomarker in prostate cancer remains uncertain due to the methodological heterogeneity of published studies. Objective: To map and synthesize the available evidence regarding the clinical role of D-dimer in the diagnosis, monitoring, and prognostic assessment of prostate cancer. Methods This scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The research question was developed using the Population, Concept, and Context (PCC) framework. Systematic searches were performed in PubMed/MEDLINE, SciELO, LILACS, BDENF, and Google Scholar without restrictions on language or publication date. Studies were screened independently by two reviewers using Rayyan®, followed by standardized data extraction and a descriptive synthesis of the evidence. Results Twenty-five studies, predominantly observational, were included. Substantial heterogeneity was observed in laboratory methods for D-dimer measurement, reporting units, and cutoff values. Elevated D-dimer levels were consistently associated with greater tumor burden, metastatic disease, advanced-stage cancer, and poorer prognosis. Discussion Despite the methodological variability, the available evidence consistently supported the clinical utility of D-dimer, particularly for prognostic assessment. Some studies suggested that D-dimer may have discriminatory value in distinguishing localized from metastatic disease; however, the current evidence does not support its use as a standalone diagnostic biomarker. Similarly, its role in therapeutic monitoring remains limited by the scarcity of available studies. Important gaps persist, including the lack of analytical standardization, substantial methodological heterogeneity across studies, and the absence of disease-specific reference values for patients with prostate cancer. Conclusion Current evidence indicates that D-dimer is a promising biomarker to complement the clinical assessment of patients with prostate cancer, particularly for prognostic stratification. However, its incorporation into routine clinical practice depends on the standardization of laboratory methods, the establishment of validated cutoff values, and well-designed multicenter studies to further define its clinical utility. Keywords D-dimer; Prostatic Neoplasms; Biomarkers; Prognosis; Hemostasis.
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223115128