Chemotherapy in Advanced Gastric Cancer Patients Associated with Disseminated Intravascular Coagulation
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PurposeLittle is known about the clinical features of advanced gastric cancer (AGC) combinedwith disseminated intravascular coagulation (DIC). The main objective of this studywas to determine the clinical outcome of patients with AGC complicated by DIC. Materials and MethodsWe conducted a retrospective review of 68 AGC patients diagnosed with DIC at fourtertiary medical centers between January 1995 and June 2010. ResultsSixty eight patients were included. The median age was 55 years (range, 25 to 78years). Nineteen patients received chemotherapy, whereas 49 patients received onlybest supportive care (BSC). The median overall survival (OS) of the 68 patients was16 days (95% confidence interval [CI], 11 to 21 days). Significantly prolonged OS wasobserved in the chemotherapy group, with a median survival of 61 days compared to9 days in the BSC group (p<0.001, log-rank test). Age and previous chemotherapywere another significant factors that were associated with OS in univariate analysis. In multivariate analysis, age (≥65 vs. <65; hazard ratio [HR], 0.38; 95% CI, 0.18 to0.78; p<0.001), chemotherapy (BSC vs. chemotherapy; HR 0.31; 95% CI, 0.15 to0.63; p<0.001), and previous chemotherapy (yes or no; HR, 0.49; 95% CI, 0.25 to0.98; p<0.045) were consistently independent prognostic factors that impacted OS. ConclusionOur study showed that patients with AGC complicated by DIC had very poor OS, andsuggested that chemotherapy might improve OS of these patients.
Abstract
PurposeLittle is known about the clinical features of advanced gastric cancer (AGC) combinedwith disseminated intravascular coagulation (DIC). The main objective of this studywas to determine the clinical outcome of patients with AGC complicated by DIC. Materials and MethodsWe conducted a retrospective review of 68 AGC patients diagnosed with DIC at fourtertiary medical centers between January 1995 and June 2010. ResultsSixty eight patients were included. The median age was 55 years (range, 25 to 78years). Nineteen patients received chemotherapy, whereas 49 patients received onlybest supportive care (BSC). The median overall survival (OS) of the 68 patients was16 days (95% confidence interval [CI], 11 to 21 days). Significantly prolonged OS wasobserved in the chemotherapy group, with a median survival of 61 days compared to9 days in the BSC group (p<0.001, log-rank test). Age and previous chemotherapywere another significant factors that were associated with OS in univariate analysis. In multivariate analysis, age (≥65 vs. <65; hazard ratio [HR], 0.38; 95% CI, 0.18 to0.78; p<0.001), chemotherapy (BSC vs. chemotherapy; HR 0.31; 95% CI, 0.15 to0.63; p<0.001), and previous chemotherapy (yes or no; HR, 0.49; 95% CI, 0.25 to0.98; p<0.045) were consistently independent prognostic factors that impacted OS. ConclusionOur study showed that patients with AGC complicated by DIC had very poor OS, andsuggested that chemotherapy might improve OS of these patients.
참고문헌 (16)
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