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Clotting factors and metastasis formation.

Nearly all experimental data available implicate the role of anticoagulation in the mechanism of metastases. Using 3 separate experimental tumor-host systems in mice, the growth rate of an implanted, primary tumor can be significantly reduced with sodium warfarin induced anticoagulation. In all experimental test conditions a surgically safe prothrombin time prolongation of 2 to 3 times normal increased the long-term survival, cure rate and evidence of metastatic tumor dissemination in all experimental models. While complications from bleeding were occasionally encountered, surgery could be performed safely and anticoagulation levels satisfactorily monitored and stabilized.There is good experimental documentation to warrant a proposed clinical adjuvant anticoagulation study to determine if coumadin may effect a reduction in metastatic spread and subsequent cure-rate in patients who are to undergo surgery "for cure" of localized malignant disease, particularly the sarcomas which have such tremendous propens...