Cancer Res Treat.  2014 Jan;46(1):27-32.

Chemotherapy in Advanced Gastric Cancer Patients Associated with Disseminated Intravascular Coagulation

• Hwang IG
• Choi JH
• Park SH
• Oh SY
• Kwon HC
• Lee SI
• Lim DH
• Lee GW
• Kang JH

Abstract

PURPOSE
Little is known about the clinical features of advanced gastric cancer (AGC) combined with disseminated intravascular coagulation (DIC). The main objective of this study was to determine the clinical outcome of patients with AGC complicated by DIC.
MATERIALS AND METHODS
We conducted a retrospective review of 68 AGC patients diagnosed with DIC at four tertiary medical centers between January 1995 and June 2010.
RESULTS
Sixty eight patients were included. The median age was 55 years (range, 25 to 78 years). Nineteen patients received chemotherapy, whereas 49 patients received only best supportive care (BSC). The median overall survival (OS) of the 68 patients was 16 days (95% confidence interval [CI], 11 to 21 days). Significantly prolonged OS was observed in the chemotherapy group, with a median survival of 61 days compared to 9 days in the BSC group (p<0.001, log-rank test). Age and previous chemotherapy were another significant factors that were associated with OS in univariate analysis. In multivariate analysis, age (> or =65 vs. <65; hazard ratio [HR], 0.38; 95% CI, 0.18 to 0.78; p<0.001), chemotherapy (BSC vs. chemotherapy; HR 0.31; 95% CI, 0.15 to 0.63; p<0.001), and previous chemotherapy (yes or no; HR, 0.49; 95% CI, 0.25 to 0.98; p<0.045) were consistently independent prognostic factors that impacted OS.
CONCLUSION
Our study showed that patients with AGC complicated by DIC had very poor OS, and suggested that chemotherapy might improve OS of these patients.

Keyword

Stomach neoplasms; Disseminated intravascular coagulation; Drug therapy

MeSH Terms

Dacarbazine
Disseminated Intravascular Coagulation*
Drug Therapy*
Humans
Multivariate Analysis
Retrospective Studies
Stomach Neoplasms*
Dacarbazine

Figure

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  Fig. 1 Overall survival. Patients undergoing chemotherapy had a significantly longer overall survival than best supportive care (BSC) patients (median, 61 days vs. 9 days; p<0.001).

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