Disseminated intravascular coagulation in solid tumors: Clinical and pathologic study

Disseminated intravascular coagulation (DIC) is a well known hemostatic com plication of solid tumors. We evaluated the occurrence of DIC in 1117 patie nts with solid tumors. Of these patients, 76 (6.8%) were diagnosed with DIC . There were a total of 145 bleeding and cloting , ting episodes reported i n the 76 patients, Thrombocytopenia, hypofibrinogemia, elevated D-dimer and fibrinogen degradation products were the most common coagulation abnormali ties encountered in patients with DIC. In multivariate analysis, older age (p = .0001), male gender (p = .009), advanced malignancies (p = .027), brea st cancer (p = .038) and the presence of necrosis in the tumor specimen (p = .004), emerged as independent factors significantly related to the occurr ence of DIC in patients with solid tumors. Of the 76 patients, 25 (33%) ach ieved response to treatment of DIC as defined in the study. Patients with e arly stage and advanced malignancies who developed DIC had inferior surviva l when compared with their counterparts without DIC (p = .039 and p = .005, respectively). Taken together, this study indicates that certain clinical and laboratory features are more common in patients with solid tumors who d eveloped DIC. The occurrence of DIC appears to have an independent effect o n survival of patients with cancer. Cooperative studies are encouraged to b etter address the usefulness and optimal prophylactic heparin regimen in pa tients at risk for DIC.