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KMID : 0939920140460010027
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대한암학회지
2014 Volume.46 No. 1 p.27 ~ p.32
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Chemotherapy in Advanced Gastric Cancer Patients Associated with Disseminated Intravascular Coagulation
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Hwang In-Gyu
Choi Jin-Hwa
Park Se-Hoon
Oh Sung-Yong
Kwon Hyuk-Chan
Lee Soon-Il
Lim Do-Hyoung
Lee Gyeong-Won
Kang Jung-Hun
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Abstract
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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 (≥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.
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KEYWORD
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Stomach neoplasms, Disseminated intravascular coagulation, Drug therapy
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