Article

Heparin and Survival in Cancer Patients

Department of Vascular Medicine, Academic Medical Center Amsterdam, Amsterdam, Netherlands.
Hematology/oncology clinics of North America (Impact Factor: 2.3). 08/2010; 24(4):777-84, ix-x. DOI: 10.1016/j.hoc.2010.05.003
Source: PubMed

ABSTRACT

The bi-directional association between cancer and the coagulation system has been known for almost 2 centuries. During the past 2 decades research has focused on the precise mechanisms through which cancer cells are able to induce a hypercoagulable state and how this leads to an environment favorable for cancer growth. Furthermore, the potential inhibitory effect of anticoagulant drugs on cancer progression has been explored. This article discusses these two aspects of the association.

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    ABSTRACT: To analyze the distribution of coagulation parameters in patients with primary liver cancer; explore the relationship between clinical staging, survival, and coagulation parameters by using Coxproportional hazard model; and provide a parameter for clinical management and prognosis. Coagulation parameters were evaluated in 228 patients with primary liver cancer, 52 patients with common liver disease, and 52 normal healthy controls. The relationship between primary livercancer staging and coagulation parameters wasanalyzed. Follow-up examinations were performed. The Cox proportional hazard model was used to analyze the relationship between coagulationparameters and survival. The changes in the coagulation parameters in patients with primary liver cancer were significantly different from those in normal controls. The effect of the disease on coagulation function became more obvious as the severity of liver cancer increased (p<0.05). The levels of D-dimer, fibrinogen degradation products (FDP), fibrinogen (FIB), and platelets (PLT) were negatively correlated with the long-term survival of patients with advanced liver cancer. The stages of primary liver cancer are associated with coagulation parameters. Coagulation parameters are related to survival and risk factors. Monitoring of coagulation parameters may help ensure better surveillance and treatment for liver cancer patients.
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    ABSTRACT: Objective: To explore the association of clinical staging and survival with coagulation parameters in patients with primary liver cancer by using Cox proportional hazard model so as to provide a parameter for clinical management and prognosis. Methods: Coagulation parameters were evaluated in 228 patients with primary liver cancer, 52 patients with common liver diseases and 52 healthy controls. The relationship between primary liver cancer staging and coagulation parameters was analyzed; follow-up examinations were performed. The Cox proportional hazard model was used to analyze the relationship between coagulation parameters and survival. Results: The changes of coagulation parameters in the patients with primary liver cancer were significantly different from those in the normal controls. The effect of the disease on coagulation function became more obvious as the severity of liver cancer increased (P<0.05). The levels of D-dimer, fibrinogen degradation products (FDP), fibrinogen (FIB) and platelets (PLT) were negatively correlated with the long-term survival of patients with advanced liver cancer. Conclusion: Coagulation parameters can timely and accurately reflect the lesion and risk extent in liver cancer patients. Dynamic monitoring of coagulation parameters may help ensure better surveillance and treatment for liver cancer patients.
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    ABSTRACT: Cancer is frequently associated with activation of blood coagulation, which in turn has been suggested to promote tumor growth and metastasis. Indeed, low molecular weight heparin treatment significantly prolongs the survival of a wide variety of patients with cancer. Based on this notion that anticoagulant treatment seems to benefit cancer patients, recent experiments aimed to elucidate the importance of the natural anticoagulant protein C pathways in cancer progression. Interestingly, these experiments showed that the repeated administration of exogenous activated protein C limits cancer cell extravasation in experimental animal models. In line, reducing endogenous activated protein C activity dramatically increased the number of experimental metastasis. These data thus strongly suggest that exogenous activated protein C administration may be a novel therapeutic avenue to limit cancer metastasis thereby prolonging overall survival of cancer patients. The current review provides an overview of recent data on the role of the protein C pathway in cancer metastasis. It discusses the potential of activated protein C as a novel target to reduce cancer progression, it points to several limitations of activated protein C administration in the setting of cancer cell metastasis and it suggest zymogen protein C as an attractive alternative.
    No preview · Article · Apr 2012 · Thrombosis Research
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