title: Chemotherapy in advanced gastric cancer patients associated with disseminated intravascular coagulation.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  Our study showed that patients with AGC complicated by DIC had very poor OS, and suggested that chemotherapy might improve OS of these patients.
authors: Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
authors: In Gyu
authors: IG
authors: Hwang
authors: Department of Radiation Oncology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
authors: Jin Hwa
authors: JH
authors: Choi
authors: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Se Hoon
authors: SH
authors: Park
authors: Department of Internal Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
authors: Sung Yong
authors: SY
authors: Oh
authors: Department of Internal Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.
authors: Hyuk-Chan
authors: HC
authors: Kwon
authors: Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
authors: Soon Il
authors: SI
authors: Lee
authors: Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
authors: Do Hyoung
authors: DH
authors: Lim
authors: Department of Internal Medicine, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
authors: Gyeong-Won
authors: GW
authors: Lee
authors: Department of Internal Medicine, Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
authors: Jung Hun
authors: JH
authors: Kang
keywords: Disseminated intravascular coagulation; Drug therapy; Stomach neoplasms