P-0063 Clinical Features and Outcomes of the Advanced Gastric Cancer Patients Associated with Disseminated Intravascular Coagulation

Abstract

IntroductionThe prognosis of symptomatic disseminated intravascular coagulation (DIC) associated with advanced gastric cancer (AGC) is very poor and life expectancy without treatment is only within 1month. Few systematic studies have been published on clinical outcome of AGC with DIC. To evaluate clinical manifestations and treatment outcomes of AGC with DIC. MethodsWe reviewed the medical records of this population from 5 institutions in South Korea between December 1994 and March 2010. ResultsSixty-eight patients with diagnosed AGC with DIC (by laboratory finding) were enrolled. Median age was 55 years (range, 25–78 years). twenty-nine patients (43%) had bone metastasis, and forty-six patients (67.6%) had symptomatic DIC. nineteen patients (28%) received palliative chemotherapy, and forty-nine patients (72%) received best supportive care (BSC). The median overall survival (OS) of all patients was 16 days (95% CI 11-21 days, range, 1–3190 days). The OS was significantly shorter in BSC than in the chemotherapy group (median, 11 vs 61 days, P=0.0049). In the chemotherapy group, the response to treatment was evaluable in 7 patients: two (10.5%) had a partial response, one (5.3%) had stable disease and four (84.2%) had progressive disease. the symptomatic response to treatment was evaluable in 18 patients: eight (44%) showed improvement of DIC. ConclusionBased on our experience, the prognosis of these patients is poor but chemotherapy showed prolongation of OS. We suggest that AGC with DIC patients should be considered palliative chemotherapy with intensive supportive treatment for DIC.