Evaluation of thromboembolic event, basic coagulation parameters, and associated factors in patients with colorectal cancer: a multicenter study

Abstract

BackgroundPatients with colorectal cancer are at an increased risk of hemostatic disturbances, and recent studies have shown that coagulation disorders could be the first sign of malignancy. Although coagulopathy is a significant cause of cancer-related death and disability, it is usually underestimated, and there has been no recent scientific evidence regarding the exact burden and its specific determinants. Moreover, the public health importance of the risk of coagulopathy among patients with colorectal polyps has not been addressed.Materials and methodsAn institution-based comparative cross-sectional study was conducted on a total of 500 study participants (250 colorectal cancer patients, 150 colorectal polyp patients, and 100 controls) from January to December 2022. Venous blood was collected for basic coagulation and platelet analysis. Descriptive statistics and non-parametric tests (Kruskal–Wallis and Dunn–Bonferroni pairwise comparisons) were used to compare study parameters among the groups. The test results were expressed as medians and interquartile ranges. Binary logistic regressions were fitted, and statistical significance was declared at a p-value of less than 0.05, with 95% CI.ResultsThe prevalence of coagulopathy among colorectal cancer patients was 198 (79.2%; 95% CI: 73.86, 83.64), while the prevalence was 76 (50.7%; 95% CI: 45.66, 54.34) among colorectal polyp patients. From the final model, age between 61 and 70 (AOR = 3.13: 95% CI: 1.03, 6.94), age > 70 years (AOR = 2.73: 95% CI: 1.08, 4.71), hypertension (AOR = 6.8: 95% CI: 1.07, 14.1), larger tumor size (AOR = 3.31: 95% CI: 1.11, 6.74), metastatic cancer (AOR = 5.8: 95% CI: 1.1, 14.7), and BMI ≥30 kg/m2 (AOR = 3.8: 95% CI: 2.3, 4.8) were positively associated with coagulopathy.ConclusionThis study showed that coagulopathy is a major public health concern among patients with colorectal cancer. Therefore, existing oncology care efforts should be strengthened to prevent coagulopathy among patients with colorectal cancer. Moreover, patients with colorectal polyps should receive more attention.

Bioinformatics analysis reveals link between alternative complement cascade pathway and colorectal cancer liver metastasis

“…The GO enrichment analysis of the BPs associated with the DEGs revealed that DEGs in the CRC versus CRC liver metastasis dataset were mainly enriched in platelet degranulation, regulation of blood coagulation, acute-phase response, hemostasis regulation, and regulation of coagulation, mainly related to hemostasis and platelet activation. The rst sign of malignancy may be coagulopathy [31] . The coagulation system is hyperactive in patients with malignant tumors due to the procoagulant characteristics of cancer cells, and the activity of the brinolytic system is decreased, which affects various related factors involved in the coagulation process and eventually leads to abnormal coagulation.…”

The Potential of Integrative Cancer Treatment Using Melatonin and the Challenge of Heterogeneity in Population-Based Studies: A Case Report of Colon Cancer and a Literature Review

“…Venous thromboembolism (VTE) is one of the most common causes of death and morbidity in cancer patients, and CT and immobilization contribute to an increased risk of VTE [76]. The prevalence of coagulopathy, including thrombocytopenia and APTT prolongation, has been shown in patients with CRC [6]. The elevated preoperative and postoperative level of D-dimer (the product of degradation of fibrin by fibrinolysis-mediated plasmin cleavage) and APTT may be risk factors associated with thrombotic events and bleeding, worsening the prognosis of CRC [77][78][79][80].…”

“…High heterogeneity, plasticity, and self-renewal help tumor cells avoid immune surveillance, become resistant to chemotherapy (CT) and apoptosis, and spread, creating metastatic niches. A developing tumor has both local and systemic effects on the body, which leads to cachexia, psychoneuroendocrine and immunoinflammatory imbalances, pro-tumoral cytokine production, aberrant myelopoiesis, immunosuppression, chronic inflammation, paraneoplastic syndromes, hemostatic abnormalities, and other disorders [2][3][4][5][6].…”