Thromboelastographic profiles as a tool for thrombotic risk in digestive tract cancer

M. L. Papa, F. Capasso, L. Pudore, S. Torre, S. Mango, V. Russo, P. Delrio, R. Palaia, F. Ruffolo, M. D. D'Eufemia, D. De Lucia, M. Napolitano, P. Di Micco, V. Parisi

Research output: Contribution to journalArticle

Abstract

Background: Quantification of the magnitude of thrombotic risk associated with malignancy and with anti-cancer therapy is indispensable to use anticoagulant drugs which selectively interfere with haemostatic mechanisms protecting patients from venous thromboembolism (VTE) and probably from tumor progression. However, none of activation coagulation markers has any predictive value for the occurrence of the thrombotic events in one individual patient. Current clotting methods can't reveal the overall dynamic clot formation; in contrast thromboelastographic methods specifically assess overall coagulation kinetics and its strength in whole blood. Aim: Objective of study was to evaluate if the activation of coagulation as eventually revealed by ROTEM® thromboelastometry could assess an hypercoagulable state in surgical neoplastic patients. Patients and Methods: Fifty consecutive patients with carcinoma of the digestive tract in preoperative period (23 M, 27 F aging 61.5 (45-79 years) and 147 healthy subjects (71 M, 76 F) were studied. A recent thromboelastometric method based on thrombelastography after Hartert was employed. Measurements were performed on ROTEM Coagulation Analyzer. The continuous coagulation data from 50 min course were transformed into dynamic velocity profiles of WB clot formation. Results: Standard parameters (CT, CFT, MCF) of cancer patients were similar to controls. CT (in cancer patients): females 50 s (38.3-58.7), males 50 s (42-71.2) vs 51 s (42-59), p = 0.1210 / 53 s (42-74.8), p = 0.1975 (in controls). CFT (in cancer patients): females 72 s (32-92.4), males 80 s (50.2-128.7) vs 78 s (62-100), p = 0.0128 / 80 s (59-124.4), p = 0.9384 (in controls). MCF (in cancer patients): females 70 mm (59.9-82.5), males 63 mm (56-73.7) vs 69 mm (59-95.8), p = 0.9911 / 69 mm (53.6-90), p = 0.0135 (in controls). Females showed a higher MaxVel when compared to males. The MaxVel was increased in cancer patients: females 19 mm / 100 s (14.3-49.5) males 18 mm / 100 s (11-27) vs 15 mm 100 s (11.8-22), p <0.001 / 13 mm / 100 s (10-21.8) p <0.001 in controls. The t-MaxVel was shortened in cancer patients: females 65 s (48.6-112.8), males 81 s (50.1-135.9) vs 115 s (56.8-166), p <0.001 / 115 s (59.8-180.8), p = 0.0002 in controls. The AUC was increased in cancer patients: females 6451 mm 100 (5511-8148), males 5984 mm 100 (5119-6899) vs 5778 mm 100 (4998-6655), p <0.001 / 5662 mm 100 (4704-6385), p = 0.0105. Conclusion: Unlike other assays measuring variations in a single component during coagulation, the thrombelastographic method records a profile of real-time continuous WB clot formation, and may provide extensive informations on haemostasis in neoplastic patients before surgery.

Original languageEnglish
Pages (from-to)111-115
Number of pages5
JournalExperimental Oncology
Volume29
Issue number2
Publication statusPublished - Jun 2007

Fingerprint

Gastrointestinal Tract
Neoplasms
Thrombelastography
Preoperative Period
Venous Thromboembolism
Hemostatics
Hemostasis
Anticoagulants
Area Under Curve
Healthy Volunteers
Carcinoma

Keywords

  • Cancer
  • Hypercoagulable state
  • Surgery
  • Thromboelastography
  • Thromboelastometry

ASJC Scopus subject areas

  • Cancer Research

Cite this

Papa, M. L., Capasso, F., Pudore, L., Torre, S., Mango, S., Russo, V., ... Parisi, V. (2007). Thromboelastographic profiles as a tool for thrombotic risk in digestive tract cancer. Experimental Oncology, 29(2), 111-115.

Thromboelastographic profiles as a tool for thrombotic risk in digestive tract cancer. / Papa, M. L.; Capasso, F.; Pudore, L.; Torre, S.; Mango, S.; Russo, V.; Delrio, P.; Palaia, R.; Ruffolo, F.; D'Eufemia, M. D.; De Lucia, D.; Napolitano, M.; Di Micco, P.; Parisi, V.

In: Experimental Oncology, Vol. 29, No. 2, 06.2007, p. 111-115.

Research output: Contribution to journalArticle

Papa, ML, Capasso, F, Pudore, L, Torre, S, Mango, S, Russo, V, Delrio, P, Palaia, R, Ruffolo, F, D'Eufemia, MD, De Lucia, D, Napolitano, M, Di Micco, P & Parisi, V 2007, 'Thromboelastographic profiles as a tool for thrombotic risk in digestive tract cancer', Experimental Oncology, vol. 29, no. 2, pp. 111-115.
Papa ML, Capasso F, Pudore L, Torre S, Mango S, Russo V et al. Thromboelastographic profiles as a tool for thrombotic risk in digestive tract cancer. Experimental Oncology. 2007 Jun;29(2):111-115.
Papa, M. L. ; Capasso, F. ; Pudore, L. ; Torre, S. ; Mango, S. ; Russo, V. ; Delrio, P. ; Palaia, R. ; Ruffolo, F. ; D'Eufemia, M. D. ; De Lucia, D. ; Napolitano, M. ; Di Micco, P. ; Parisi, V. / Thromboelastographic profiles as a tool for thrombotic risk in digestive tract cancer. In: Experimental Oncology. 2007 ; Vol. 29, No. 2. pp. 111-115.
@article{ec6a8e79777a4b46835e5f6f4d48a9bf,
title = "Thromboelastographic profiles as a tool for thrombotic risk in digestive tract cancer",
abstract = "Background: Quantification of the magnitude of thrombotic risk associated with malignancy and with anti-cancer therapy is indispensable to use anticoagulant drugs which selectively interfere with haemostatic mechanisms protecting patients from venous thromboembolism (VTE) and probably from tumor progression. However, none of activation coagulation markers has any predictive value for the occurrence of the thrombotic events in one individual patient. Current clotting methods can't reveal the overall dynamic clot formation; in contrast thromboelastographic methods specifically assess overall coagulation kinetics and its strength in whole blood. Aim: Objective of study was to evaluate if the activation of coagulation as eventually revealed by ROTEM{\circledR} thromboelastometry could assess an hypercoagulable state in surgical neoplastic patients. Patients and Methods: Fifty consecutive patients with carcinoma of the digestive tract in preoperative period (23 M, 27 F aging 61.5 (45-79 years) and 147 healthy subjects (71 M, 76 F) were studied. A recent thromboelastometric method based on thrombelastography after Hartert was employed. Measurements were performed on ROTEM Coagulation Analyzer. The continuous coagulation data from 50 min course were transformed into dynamic velocity profiles of WB clot formation. Results: Standard parameters (CT, CFT, MCF) of cancer patients were similar to controls. CT (in cancer patients): females 50 s (38.3-58.7), males 50 s (42-71.2) vs 51 s (42-59), p = 0.1210 / 53 s (42-74.8), p = 0.1975 (in controls). CFT (in cancer patients): females 72 s (32-92.4), males 80 s (50.2-128.7) vs 78 s (62-100), p = 0.0128 / 80 s (59-124.4), p = 0.9384 (in controls). MCF (in cancer patients): females 70 mm (59.9-82.5), males 63 mm (56-73.7) vs 69 mm (59-95.8), p = 0.9911 / 69 mm (53.6-90), p = 0.0135 (in controls). Females showed a higher MaxVel when compared to males. The MaxVel was increased in cancer patients: females 19 mm / 100 s (14.3-49.5) males 18 mm / 100 s (11-27) vs 15 mm 100 s (11.8-22), p <0.001 / 13 mm / 100 s (10-21.8) p <0.001 in controls. The t-MaxVel was shortened in cancer patients: females 65 s (48.6-112.8), males 81 s (50.1-135.9) vs 115 s (56.8-166), p <0.001 / 115 s (59.8-180.8), p = 0.0002 in controls. The AUC was increased in cancer patients: females 6451 mm 100 (5511-8148), males 5984 mm 100 (5119-6899) vs 5778 mm 100 (4998-6655), p <0.001 / 5662 mm 100 (4704-6385), p = 0.0105. Conclusion: Unlike other assays measuring variations in a single component during coagulation, the thrombelastographic method records a profile of real-time continuous WB clot formation, and may provide extensive informations on haemostasis in neoplastic patients before surgery.",
keywords = "Cancer, Hypercoagulable state, Surgery, Thromboelastography, Thromboelastometry",
author = "Papa, {M. L.} and F. Capasso and L. Pudore and S. Torre and S. Mango and V. Russo and P. Delrio and R. Palaia and F. Ruffolo and D'Eufemia, {M. D.} and {De Lucia}, D. and M. Napolitano and {Di Micco}, P. and V. Parisi",
year = "2007",
month = "6",
language = "English",
volume = "29",
pages = "111--115",
journal = "Experimental Oncology",
issn = "1812-9269",
publisher = "Morion LLC",
number = "2",

}

TY - JOUR

T1 - Thromboelastographic profiles as a tool for thrombotic risk in digestive tract cancer

AU - Papa, M. L.

AU - Capasso, F.

AU - Pudore, L.

AU - Torre, S.

AU - Mango, S.

AU - Russo, V.

AU - Delrio, P.

AU - Palaia, R.

AU - Ruffolo, F.

AU - D'Eufemia, M. D.

AU - De Lucia, D.

AU - Napolitano, M.

AU - Di Micco, P.

AU - Parisi, V.

PY - 2007/6

Y1 - 2007/6

N2 - Background: Quantification of the magnitude of thrombotic risk associated with malignancy and with anti-cancer therapy is indispensable to use anticoagulant drugs which selectively interfere with haemostatic mechanisms protecting patients from venous thromboembolism (VTE) and probably from tumor progression. However, none of activation coagulation markers has any predictive value for the occurrence of the thrombotic events in one individual patient. Current clotting methods can't reveal the overall dynamic clot formation; in contrast thromboelastographic methods specifically assess overall coagulation kinetics and its strength in whole blood. Aim: Objective of study was to evaluate if the activation of coagulation as eventually revealed by ROTEM® thromboelastometry could assess an hypercoagulable state in surgical neoplastic patients. Patients and Methods: Fifty consecutive patients with carcinoma of the digestive tract in preoperative period (23 M, 27 F aging 61.5 (45-79 years) and 147 healthy subjects (71 M, 76 F) were studied. A recent thromboelastometric method based on thrombelastography after Hartert was employed. Measurements were performed on ROTEM Coagulation Analyzer. The continuous coagulation data from 50 min course were transformed into dynamic velocity profiles of WB clot formation. Results: Standard parameters (CT, CFT, MCF) of cancer patients were similar to controls. CT (in cancer patients): females 50 s (38.3-58.7), males 50 s (42-71.2) vs 51 s (42-59), p = 0.1210 / 53 s (42-74.8), p = 0.1975 (in controls). CFT (in cancer patients): females 72 s (32-92.4), males 80 s (50.2-128.7) vs 78 s (62-100), p = 0.0128 / 80 s (59-124.4), p = 0.9384 (in controls). MCF (in cancer patients): females 70 mm (59.9-82.5), males 63 mm (56-73.7) vs 69 mm (59-95.8), p = 0.9911 / 69 mm (53.6-90), p = 0.0135 (in controls). Females showed a higher MaxVel when compared to males. The MaxVel was increased in cancer patients: females 19 mm / 100 s (14.3-49.5) males 18 mm / 100 s (11-27) vs 15 mm 100 s (11.8-22), p <0.001 / 13 mm / 100 s (10-21.8) p <0.001 in controls. The t-MaxVel was shortened in cancer patients: females 65 s (48.6-112.8), males 81 s (50.1-135.9) vs 115 s (56.8-166), p <0.001 / 115 s (59.8-180.8), p = 0.0002 in controls. The AUC was increased in cancer patients: females 6451 mm 100 (5511-8148), males 5984 mm 100 (5119-6899) vs 5778 mm 100 (4998-6655), p <0.001 / 5662 mm 100 (4704-6385), p = 0.0105. Conclusion: Unlike other assays measuring variations in a single component during coagulation, the thrombelastographic method records a profile of real-time continuous WB clot formation, and may provide extensive informations on haemostasis in neoplastic patients before surgery.

AB - Background: Quantification of the magnitude of thrombotic risk associated with malignancy and with anti-cancer therapy is indispensable to use anticoagulant drugs which selectively interfere with haemostatic mechanisms protecting patients from venous thromboembolism (VTE) and probably from tumor progression. However, none of activation coagulation markers has any predictive value for the occurrence of the thrombotic events in one individual patient. Current clotting methods can't reveal the overall dynamic clot formation; in contrast thromboelastographic methods specifically assess overall coagulation kinetics and its strength in whole blood. Aim: Objective of study was to evaluate if the activation of coagulation as eventually revealed by ROTEM® thromboelastometry could assess an hypercoagulable state in surgical neoplastic patients. Patients and Methods: Fifty consecutive patients with carcinoma of the digestive tract in preoperative period (23 M, 27 F aging 61.5 (45-79 years) and 147 healthy subjects (71 M, 76 F) were studied. A recent thromboelastometric method based on thrombelastography after Hartert was employed. Measurements were performed on ROTEM Coagulation Analyzer. The continuous coagulation data from 50 min course were transformed into dynamic velocity profiles of WB clot formation. Results: Standard parameters (CT, CFT, MCF) of cancer patients were similar to controls. CT (in cancer patients): females 50 s (38.3-58.7), males 50 s (42-71.2) vs 51 s (42-59), p = 0.1210 / 53 s (42-74.8), p = 0.1975 (in controls). CFT (in cancer patients): females 72 s (32-92.4), males 80 s (50.2-128.7) vs 78 s (62-100), p = 0.0128 / 80 s (59-124.4), p = 0.9384 (in controls). MCF (in cancer patients): females 70 mm (59.9-82.5), males 63 mm (56-73.7) vs 69 mm (59-95.8), p = 0.9911 / 69 mm (53.6-90), p = 0.0135 (in controls). Females showed a higher MaxVel when compared to males. The MaxVel was increased in cancer patients: females 19 mm / 100 s (14.3-49.5) males 18 mm / 100 s (11-27) vs 15 mm 100 s (11.8-22), p <0.001 / 13 mm / 100 s (10-21.8) p <0.001 in controls. The t-MaxVel was shortened in cancer patients: females 65 s (48.6-112.8), males 81 s (50.1-135.9) vs 115 s (56.8-166), p <0.001 / 115 s (59.8-180.8), p = 0.0002 in controls. The AUC was increased in cancer patients: females 6451 mm 100 (5511-8148), males 5984 mm 100 (5119-6899) vs 5778 mm 100 (4998-6655), p <0.001 / 5662 mm 100 (4704-6385), p = 0.0105. Conclusion: Unlike other assays measuring variations in a single component during coagulation, the thrombelastographic method records a profile of real-time continuous WB clot formation, and may provide extensive informations on haemostasis in neoplastic patients before surgery.

KW - Cancer

KW - Hypercoagulable state

KW - Surgery

KW - Thromboelastography

KW - Thromboelastometry

UR - http://www.scopus.com/inward/record.url?scp=34548155256&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34548155256&partnerID=8YFLogxK

M3 - Article

C2 - 17704742

AN - SCOPUS:34548155256

VL - 29

SP - 111

EP - 115

JO - Experimental Oncology

JF - Experimental Oncology

SN - 1812-9269

IS - 2

ER -