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948, 3.224]; P .001) and PFS (15.8% vs 34.0%; random effects RR = 1.294; 95% CI = [1.060, 1.579]; P = .011) rates than those with normal level of D-dimer. Moreover, high pretreatment D-dimer level was further proved to remain as an unfavorable predictor of OS (fixed effects HR = 1.865; 95% CI = [1.469, 2.367]; P .001; I2 = 7.6%) and PFS (fixed effects HR = 1.513; 95% CI = [1.183, 1.936]; P = .001; I2 = 0.0%) in patients with SCLC. High pretreatment level of D-dimer was found to be an independent unfavorable prognostic factor i