Osteosarcoma: improved survival with anticoagulation and amputation.
A study of warfarin anticoagulation as an adjunct to amputation of osteosarcomas was undertaken after finding dramatic results in experimental systems. Anticoagulation was started 7 days preoperatively, continued during the operation, and for up to six months postoperatively. Three of 21 (14%) non-anticoagulated control patients are alive at 5-11 years. Five of 9 (56%) of the anticoagulated patients remain alive 5-8 years. The presumed mechanism of increased survival is an inhibition of fibrin deposition around circulating tumor cells, thereby preventing their adherence to capillary endothelium to initiate metastasis formation.
D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D001859:Bone Neoplasms / Q000097:blood / Q000628:therapy*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000517:prevention & control; D009360:Neoplastic Cells, Circulating; D012516:Osteosarcoma / Q000097:blood / Q000628:therapy*; D011517:Prothrombin Time; D012075:Remission, Spontaneous; D013997:Time Factors; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use*
D014859:Warfarin