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Rectal bleeding and previous anticoagulant treatment in patients with colorectal cancer do not predict outcome

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Abstract

Background

The aim of this study was to determine whether the outcome of patients with colorectal cancer who presented with bleeding and a history of anticoagulant treatment was different from those who did not have bleeding or previous anticoagulant treatment.

Methods

This was a single institution, retrospective study of patients with colorectal cancer with and without a history of rectal bleeding and treatment with anticoagulants, assessed for age, gender, tumor site, stage, recurrence rate, and survival.

Results

A total of 621 consecutive patients (309 men) with a mean age of 70 years (range, 36–44 years) diagnosed with colorectal cancer between 1998 and 2004 were studied. Of these, 149 patients (24%) were referred for symptoms of rectal bleeding and 161 patients (26%) had been previously treated with anticoagulants. A total of 592 patients (95%) underwent curative or palliative surgery; endoscopic polypectomy was performed in 3 cases only and in 26 patients (4%) surgery was not performed due to advanced disease or critical illness. Patients with bleeding and a history of anticoagulant treatment presented commonly with stage I cancer. In addition, tumor stage III was less common in patients with previous anticoagulant treatment irrespective of presenting signs. Disease-free and overall survival rates were similar in all groups, irrespective of bleeding at presentation or anticoagulant treatment.

Conclusions

Rectal bleeding and anticoagulant treatment do not affect the outcome of newly diagnosed patients with colorectal cancer.

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References

  1. Steward BW (2003) Colorectal cancer. World Cancer Report. IARC, Lyon, pp 198–202

    Google Scholar 

  2. Jemal A, Tiwari RC, Murray T et al (2004) Cancer statistics, 2004. CA Cancer J Clin 54:8–29

    Article  PubMed  Google Scholar 

  3. Selby JV, Friedman GD, Quesenberry CP Jr, Weiss NS (1992) A case-control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med 326:653–657

    Article  CAS  PubMed  Google Scholar 

  4. Kronborg O, Fenger C, Olsen J et al (1996) Randomised study of screening for colorectal cancer with faecal-occult-blood test. Lancet 348:1467–1471

    Article  CAS  PubMed  Google Scholar 

  5. Walsh JM, Terdiman JP (2003) Colorectal cancer screening: scientific review. JAMA 289:1288–1296

    Article  PubMed  Google Scholar 

  6. Serrano D, Lazzeroni M, Decensi A (2004) Chemoprevention of colorectal cancer: an update. Tech Coloproctol 8[Suppl 2]:S248–S252

    Article  PubMed  Google Scholar 

  7. Carey RJ (1984) Warfarin-induced rectal bleeding as clue to colon cancer. Lancet 1:505–506

    Article  CAS  PubMed  Google Scholar 

  8. Baker JW, Mitchell SJ, Dixon AR (2002) Early diagnosis of colonic carcinoma: a haemorrhagic complication after the use of tissue plasminogen activator. Postgrad Med J 78:429

    Article  CAS  PubMed  Google Scholar 

  9. Norton SA, Armstrong CP (1997) Lower gastrointestinal bleeding during anticoagulant therapy: a life-saving complication? Ann R Coll Surg Engl 79:38–39

    CAS  PubMed  Google Scholar 

  10. Shin SJ, Kim BC, Park S, Kim S, Kim TI, Kim WH (2005) Characteristics of colon cancer diagnosed in patients taking aspirin or warfarin. Korean J Gastroenterol 46:455–462 (in Korean)

    PubMed  Google Scholar 

  11. Gray R (2003) 5′fluorouracil (FU) and folinic acis (FA) in either the weekly “Roswell Park” or the 4-weekly “Mayo” regimen should be standard chemotheraphy for colon cancer. Eur J Cancer 39:2110

    Article  PubMed  Google Scholar 

  12. Talley NJ, Jones M (1998) Self-reported rectal bleeding in a United States community: prevalence, risk factors, and health care seeking. Am J Gastroenterol 93:2179–2183

    Article  CAS  PubMed  Google Scholar 

  13. Helfand M, Marton KI, Zimmer-Gembeck MJ, Sox HC Jr (1997) History of visible rectal bleeding in a primary care population. Initial assessment and 10-year follow-up. JAMA 277:44–48

    Article  CAS  PubMed  Google Scholar 

  14. Wauters H, Van Casteren V, Buntinx F (2000) Rectal bleeding and colorectal cancer in general practice: diagnostic study. BMJ 321:998–999

    Article  CAS  PubMed  Google Scholar 

  15. Fijten GH, Muris JW, Starmans R, Knottnerus JA, Blijham GH, Krebber TF (1993) The incidence and outcome of rectal bleeding in general practice. Fam Pract 10:283–287

    Article  CAS  PubMed  Google Scholar 

  16. Ellis BG, Thompson MR (2005) Factors identifying higher risk rectal bleeding in general practice. Br J Gen Pract 55:949–955

    PubMed  Google Scholar 

  17. Asano TK, McLeod RS (2004) Non-steroidal anti-inflammatory drugs (NSAID) and aspirin for preventing colorectal adenomas and carcinomas. Cochrane Database Syst Rev CD004079

  18. Thun MJ (1997) Aspirin and gastrointestinal cancer. Adv Exp Med Biol 400A:395–402

    CAS  PubMed  Google Scholar 

  19. Sandler RS (1996) Aspirin and other nonsteroidal anti-inflammatory agents in the prevention of colorectal cancer. Important Adv Oncol 1996:123–137

    Google Scholar 

  20. Baron JA (2003) Epidemiology of non-steroidal anti-inflammatory drugs and cancer. Prog Exp Tumor Res 37:1–24

    Article  Google Scholar 

  21. Hejna M, Raderer M, Zielinski CC (1999) Inhibition of metastases by anticoagulants. J Natl Cancer Inst 91:22–36

    Article  CAS  PubMed  Google Scholar 

  22. Zacharski LR, Meehan KR, Algarra SM, Calvo FA (1992) Clinical trials with anticoagulant and antiplatelet therapies. Cancer Metastasis Rev 11:421–431

    Article  CAS  PubMed  Google Scholar 

  23. Bobek V, Boubelik M, Fiserova A et al (2005) Anticoagulant drugs increase natural killer cell activity in lung cancer. Lung Cancer 47:215–223

    Article  CAS  PubMed  Google Scholar 

  24. Bobek V, Kovarik J (2004) Antitumor and antimetastatic effect of warfarin and heparins. Biomed Pharmacother 58:213–219

    Article  CAS  PubMed  Google Scholar 

  25. Klein-Soyer C, Ceraline J, Orvain C, de la Salle C, Bergerat JP, Cazenave JP (1997) Angiogenesis inhibitor SR 25989 upregulates thrombospondin-1 expression in human vascular endothelial cells and foreskin fibroblasts. Biol Cell 89:295–307

    Article  CAS  PubMed  Google Scholar 

  26. Mah-Becherel MC, Ceraline J, Deplanque G et al (2002) Antiangiogenic effects of the thienopyridine SR 25989 in vitro and in vivo in a murine pulmonary metastasis model. Br J Cancer 86:803–810

    Article  CAS  PubMed  Google Scholar 

  27. Zacharski LR, Henderson WG, Rickles FR et al (1984) Effect of warfarin anticoagulation on survival in carcinoma of the lung, colon, head and neck, and prostate. Final report of VA Cooperative Study #75. Cancer 53:2046–2052

    Article  CAS  PubMed  Google Scholar 

  28. Bobek V, Boubelik M, Kovarik J, Taltynov O (2003) Inhibition of adhesion breast cancer cells by anticoagulant drugs and cimetidine. Neoplasma 50:148–151

    CAS  PubMed  Google Scholar 

  29. Stanford CF (1979) Anticoagulants in the treatment of small cell carcinoma of the bronchus. Thorax 34:113–116

    Article  CAS  PubMed  Google Scholar 

  30. Lipton A, Scialla S, Harvey H et al (1982) Adjuvant antiplatelet therapy with aspirin in colo-rectal cancer. J Med 13:419–429

    CAS  PubMed  Google Scholar 

  31. Torngren S, Rieger A (1983) The influence of heparin and curable resection on the survival of colorectal cancer. Acta Chir Scand 149:427–429

    CAS  PubMed  Google Scholar 

References

  1. Hardcastle JD, Chamberlain JO, Robinson MH et al (1996) Randomised controlled trial of faecal-occult-blood screening for colorectal cancer. Lancet 348:1472–1477

    Article  CAS  PubMed  Google Scholar 

  2. Kronborg O, Fenger C, Olsen J, Jorgensen OD, Sondergaard O (1996) Randomised study of screening for colorectal cancer with faecal-occult-blood test. Lancet 348:1467–1471

    Article  CAS  PubMed  Google Scholar 

  3. Bresalier RS, Sandler RS, Quan H et al (2005) Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. N Engl J Med 352:1092–1102

    Article  CAS  PubMed  Google Scholar 

  4. Hejna M, Raderer M, Zielinski CC (1999) Inhibition of metastases by anticoagulants. J Natl Cancer Inst 91:22–36

    Article  CAS  PubMed  Google Scholar 

  5. Chahinian AP, Propert KJ, Ware JH et al (1989) Arandomized trial of anticoagulation with warfarin and of alternating chemotherapy in extensive small-cell lung cancer by the Cancer and Leukemia Group B. J Clin Oncol 7:993–1002

    CAS  PubMed  Google Scholar 

  6. Zacharski LR, Henderson WG, Rickles FR et al (1984) Effect of warfarin anticoagulation on survival in carcinoma of the lung, colon, head and neck, and prostate. Final report of VA Cooperative Study #75. Cancer 53:2046–2052

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery A Soroka University Medical Center, Ben-Gurion University of the Negev, P.O. Box 151, Beer-Sheva, 84101, Israel

    B. Kirshtein & S. Mizrahi

  2. Department of Oncology, Soroka University Medical Center, Beer-Sheva, Israel

    S. Ariad & S. Man

  3. Department of Surgery B and Colorectal Unit, Soroka University Medical Center, Beer-Sheva, Israel

    S. Walfisch

  4. Colorectal Surgery Division, University of São Paulo School of Medicine, São Paulo, Brazil

    R. O. Perez

Authors
  1. B. Kirshtein
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  2. S. Ariad
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  3. S. Mizrahi
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  4. S. Man
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  5. S. Walfisch
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  6. R. O. Perez
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Correspondence to B. Kirshtein.

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Kirshtein, B., Ariad, S., Mizrahi, S. et al. Rectal bleeding and previous anticoagulant treatment in patients with colorectal cancer do not predict outcome. Tech Coloproctol 11, 121–127 (2007). https://doi.org/10.1007/s10151-007-0341-2

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  • DOI: https://doi.org/10.1007/s10151-007-0341-2

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