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Hypercoagulability as a prognostic factor for survival in patients with metastatic renal cell carcinoma.

Tsimafeyeu IV, Demidov LV, Madzhuga AV, Somonova OV, Yelizarova AL - J. Exp. Clin. Cancer Res. (2009)

Bottom Line: Serious disorders were found in 68% of patients.Abnormal coagulation was strongly associated with a number of metastatic sites (2 and more metastatic sites vs. 0-1 (P = .001).Median survival was 8.2 months and 14.6 months, respectively (P = .0011).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Biotherapy, Clinical Research Laboratory, N.N. Blokhin Russian Cancer Research Center, Kidney Cancer Research Bureau, Moscow, Russia. office@kidneytumor.org

ABSTRACT

Background: In experimental systems, interference with coagulation can affect tumor biology. We suggested that abnormal coagulation could be a negative predictor for response to immunotherapy and survival among patients with metastatic renal cell carcinoma (MRCC).

Methods: To address this issue, retrospective analysis of 289 previously untreated MRCC patients entering on institutional review board-approved clinical trials was conducted between 2003 and 2006. In addition, two groups of MRCC patients with (n = 28) or without (n = 28) hypercoagulability were compared in a case-control study. Baseline and treatment characteristics were well balanced.

Results: Hypercoagulability was present at treatment start in 40% of patients. Median baseline fibrinogen was 6.2 mg/dl. Serious disorders were found in 68% of patients. Abnormal coagulation was strongly associated with a number of metastatic sites (2 and more metastatic sites vs. 0-1 (P = .001). Patients with high extent of hypercoagulability had significantly higher number of metastatic sites (P = .02). On univariate analysis, patients with hypercoagulability had significantly shorter overall survival than patients with normal coagulation; median survivals of 8.9 and 16.3, respectively (P = .001).Short survival and low response rate also were significantly associated with hypercoagulability in a case-control study. Median survival was 8.2 months and 14.6 months, respectively (P = .0011). Disease control rate (overall response + stable disease) was significantly higher in patients with normal coagulation: 71.4 versus 42.9% (P = .003).

Conclusion: Hypercoagulability disorders were found to be prognostic factor for response rate to systemic therapy and survival in patients with MRCC.

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Related in: MedlinePlus

Overall survival (Kaplan-Meier analysis). Median overall survival was 8.2 months for group with hypercoagulability, and 14.6 months for group with normal coagulation. Differences were significant (HR = .54, P = .0011).
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Figure 1: Overall survival (Kaplan-Meier analysis). Median overall survival was 8.2 months for group with hypercoagulability, and 14.6 months for group with normal coagulation. Differences were significant (HR = .54, P = .0011).

Mentions: In Kaplan-Meier analysis, patients with hypercoagulability had a significantly shorter overall survival than patients with normal coagulation. Median survival was 8.2 (95%CI 7.2–9.2) and 14.6 (95%CI 12.4–16.8) months, respectively (HR = .54, P = .0011). Survival curves are given in Figure 1.


Hypercoagulability as a prognostic factor for survival in patients with metastatic renal cell carcinoma.

Tsimafeyeu IV, Demidov LV, Madzhuga AV, Somonova OV, Yelizarova AL - J. Exp. Clin. Cancer Res. (2009)

Overall survival (Kaplan-Meier analysis). Median overall survival was 8.2 months for group with hypercoagulability, and 14.6 months for group with normal coagulation. Differences were significant (HR = .54, P = .0011).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2654863&req=5

Figure 1: Overall survival (Kaplan-Meier analysis). Median overall survival was 8.2 months for group with hypercoagulability, and 14.6 months for group with normal coagulation. Differences were significant (HR = .54, P = .0011).
Mentions: In Kaplan-Meier analysis, patients with hypercoagulability had a significantly shorter overall survival than patients with normal coagulation. Median survival was 8.2 (95%CI 7.2–9.2) and 14.6 (95%CI 12.4–16.8) months, respectively (HR = .54, P = .0011). Survival curves are given in Figure 1.

Bottom Line: Serious disorders were found in 68% of patients.Abnormal coagulation was strongly associated with a number of metastatic sites (2 and more metastatic sites vs. 0-1 (P = .001).Median survival was 8.2 months and 14.6 months, respectively (P = .0011).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Biotherapy, Clinical Research Laboratory, N.N. Blokhin Russian Cancer Research Center, Kidney Cancer Research Bureau, Moscow, Russia. office@kidneytumor.org

ABSTRACT

Background: In experimental systems, interference with coagulation can affect tumor biology. We suggested that abnormal coagulation could be a negative predictor for response to immunotherapy and survival among patients with metastatic renal cell carcinoma (MRCC).

Methods: To address this issue, retrospective analysis of 289 previously untreated MRCC patients entering on institutional review board-approved clinical trials was conducted between 2003 and 2006. In addition, two groups of MRCC patients with (n = 28) or without (n = 28) hypercoagulability were compared in a case-control study. Baseline and treatment characteristics were well balanced.

Results: Hypercoagulability was present at treatment start in 40% of patients. Median baseline fibrinogen was 6.2 mg/dl. Serious disorders were found in 68% of patients. Abnormal coagulation was strongly associated with a number of metastatic sites (2 and more metastatic sites vs. 0-1 (P = .001). Patients with high extent of hypercoagulability had significantly higher number of metastatic sites (P = .02). On univariate analysis, patients with hypercoagulability had significantly shorter overall survival than patients with normal coagulation; median survivals of 8.9 and 16.3, respectively (P = .001).Short survival and low response rate also were significantly associated with hypercoagulability in a case-control study. Median survival was 8.2 months and 14.6 months, respectively (P = .0011). Disease control rate (overall response + stable disease) was significantly higher in patients with normal coagulation: 71.4 versus 42.9% (P = .003).

Conclusion: Hypercoagulability disorders were found to be prognostic factor for response rate to systemic therapy and survival in patients with MRCC.

Show MeSH
Related in: MedlinePlus