warfarin and Colonic-Neoplasms

VA Cooperative Study #75 was established to test in a controlled, randomized trial the hypothesis that warfarin anticoagulation would favorably affect the course of certain types of malignancy. No differences in survival were observed between warfarin-treated and control groups for advanced non-small cell lung, colorectal, head and neck and prostate cancers. However, warfarin therapy was associated with a significant prolongation in the time to first evidence of disease progression (P = 0.016) and a significant improvement in survival (P = 0.018) for patients with small cell carcinoma of the lung, including the subgroup of patients with disseminated disease at the time of randomization (P = 0.013). A trend toward improved survival with warfarin treatment was observed for the few patients admitted to this study with non-small cell lung cancer who had minimal disease at randomization. These results suggest that warfarin, as a single anticoagulant agent, may favorably modify the course of some, but not all, types of human malignancy, among which is small cell carcinoma of the lung. Further trials of warfarin may be indicated in patients with limited disease who have cell types that failed to respond when advanced disease was present.

Topics: Adenocarcinoma; Blood Coagulation; Carcinoma, Small Cell; Clinical Trials as Topic; Colonic Neoplasms; Female; Head and Neck Neoplasms; Humans; Lung Neoplasms; Male; Neoplasm Metastasis; Prostatic Neoplasms; Random Allocation; Warfarin

The value of the oral anticoagulant warfarin sodium and fibrinolytic agents is discussed in relation to cancer surgery. A controlled trial of 128 patients showed that in a variety of recurrent cases the addition of warfarin to chemotherapy doubled the 2-year survival rate. The best results were obtained in postmenopausal patients with breast cancer. Warfarin depresses cellular immune responses which might militate against its use for cases undergoing "curative" surgery. Instead, induction of fibrinolysis by streptokinase or Brinase is suggested, because it increases the activity of the cellular immune mechanism. The results to date of an ongoing controlled randomized trial of streptokinase with surgery of tumors of the large bowel are presented, showing that the trends are in favor of streptokinase therapy; however, insufficient time has elapsed to make it, as yet, statistically significant. The action of streptokinase-induced plasmin and Brinase on lymphocytes is described.

Topics: Adenocarcinoma; Administration, Oral; Antineoplastic Agents; Aspergillus; Breast Neoplasms; Colonic Neoplasms; Drug Evaluation; Female; Fibrinolysis; Fibrinolytic Agents; Humans; Immunity, Cellular; Lymphoma, Non-Hodgkin; Male; Neoplasms; Ovarian Neoplasms; Peptide Hydrolases; Rectal Neoplasms; Streptokinase; Warfarin

Spontaneous superior ophthalmic vein thrombosis (SOVT) is a rare entity. We describe three patients with spontaneous ophthalmic vein thrombosis, each with various risk factors.. A retrospective review of three patients with a diagnosis of superior ophthalmic vein thrombosis. Clinical characteristics, radiographic features, management techniques and outcomes are described.. All patients presented with unilateral painful proptosis. Two patients had intact light perception, whereas one patient presented with absent light perception. All patients had identifiable risk factors for thrombosis, which included sickle cell trait, hereditary hemorrhagic telangectasia and colon cancer with recurrent deep vein thrombosis. Anticoagulation was initiated in two patients. Resolution of proptosis was seen in all patients, with no recovery of vision in one patient.. Risk factors for spontaneous superior ophthalmic vein thrombosis are multifactorial. MRI and MRV confirm the diagnosis of SOVT. Despite urgent intervention devastating visual loss may occur.

Topics: Administration, Oral; Adult; Aged; Anticoagulants; Antihypertensive Agents; Colonic Neoplasms; Exophthalmos; Eye; Eye Pain; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Retrospective Studies; Risk Factors; Sickle Cell Trait; Telangiectasia, Hereditary Hemorrhagic; Tomography, X-Ray Computed; Veins; Venous Thrombosis; Visual Acuity; Warfarin

To determine the effect of anticoagulants and antiplatelet medications on the positive-predictive-value of fecal occult blood test (FOBT).. All patients who underwent a colonoscopy at our institution from 1995 to 2006 for a positive FOBT were identified. Medical records were searched, and patients were stratified into five groups selected a priori: low-dose aspirin, NSAIDs, warfarin, clopidogrel, or controls. The positive-predictive-value of FOBT for advanced colonic neoplasia was computed for each group.. During the study period, 1,126 patients underwent colonoscopy for a positive FOBT and met entry criteria. The average age of study participants was 69 years and most were men. The positive-predictive-value of FOBT for advanced colon neoplasia was significantly higher in the control group (30.5%) when compared to those on low-dose aspirin (20.5%; p = 0.003), NSAIDs (19.7%; p = 0.003), clopidogrel (7.3%; p = 0.002), or warfarin (20%; p = 0.05). The positive-predictive-value of FOBT was significantly lower for those on clopidogrel than those on low-dose aspirin (p = 0.04) and NSAIDs (p = 0.05), but not warfarin (p = 0.08). The positive-predictive-value for FOBT was similar for those on aspirin, NSAIDs, and warfarin. There was a linear trend between the number of number of positive FOBT cards and prevalence of advanced colon neoplasia (p = 0.01).. Anticoagulants and antiplatelet medications lower the positive-predictive-value of FOBT for advance colonic neoplasia and should be stopped if clinically feasible prior to stool collection.

Topics: Aged; Anti-Inflammatory Agents, Non-Steroidal; Anticoagulants; Aspirin; Clopidogrel; Colonic Neoplasms; Colonoscopy; Female; Gastrointestinal Hemorrhage; Humans; Logistic Models; Male; Mass Screening; Middle Aged; Occult Blood; Odds Ratio; Platelet Aggregation Inhibitors; Predictive Value of Tests; Retrospective Studies; Ticlopidine; Unnecessary Procedures; Warfarin

Topics: Anti-Inflammatory Agents, Non-Steroidal; Anticoagulants; Aspirin; Clopidogrel; Colonic Neoplasms; Colonoscopy; Gastrointestinal Hemorrhage; Humans; Mass Screening; Occult Blood; Platelet Aggregation Inhibitors; Predictive Value of Tests; Ticlopidine; Unnecessary Procedures; Warfarin

A 64-year-old woman with colon carcinoma presented with subsegmental pulmonary emboli. Platelet count on presentation was 598 x10(9)/l. The patient was anticoagulated with intravenous heparin. By hospital day 3, heparin was replaced with enoxaparin and warfarin. On hospital day 6, the patient developed a 20 x 15 cm area of necrotic skin on her left hip and a 1 x 3 cm area of necrosis on her right hip. By that time, her platelet count had fallen to 433 x 10(9)/l. Three days later (hospital day 9), anticoagulation was switched from the combination of enoxaparin and warfarin to argatroban. Her platelet count reached a nadir of 82 x 10(9)/l by the 12th hospital day. The areas of skin necrosis had never been sites of heparin injection. Heparin/platelet factor 4 antibody, sent on hospital day 9, returned positive and (14)C-serotonin release assay was also positive. This case illustrates that processes underlying heparin-induced thrombocytopenia (HIT) may also underlie warfarin-induced skin necrosis. Skin necrosis may be the earliest manifestation of HIT and need not be accompanied by thrombocytopenia. This patient's course illustrates that HIT should be considered in all patients presenting with skin necrosis while receiving anticoagulation with heparin or a combination of heparin and warfarin.

Topics: Colonic Neoplasms; Female; Heparin; Humans; Middle Aged; Necrosis; Pulmonary Embolism; Skin Diseases; Thrombocytopenia; Warfarin

Topics: Aged; Anticoagulants; Atrial Fibrillation; Colonic Neoplasms; Diagnosis, Differential; Gastrointestinal Hemorrhage; Hematoma; Humans; Male; Neoplasm Recurrence, Local; Warfarin

Concurrent use of warfarin and 5-fluorouracil has resulted in elevated international normalized ratios (INRs). Although this drug interaction is well established in the literature, we found no documented cases that address its effects on anticoagulation parameters in patients requiring repeated cycles of 5-fluorouracil and continuous warfarin therapy. We describe the effect of multiple cycles of 5-fluorouracil administration in a patient receiving warfarin therapy. The patient's INR increased 11-14 days after each cycle of chemotherapy with 5-fluorouracil and leucovorin. In addition, she required additive reductions of 33-42% in her weekly warfarin dose with each chemotherapy cycle to maintain a therapeutic INR (goal range 2.0-3.0). After three cycles of chemotherapy over a 10-week period, the patient's dosage requirements returned to her baseline level (before treatment with 5-fluorouracil and leucovorin had started). Pertinent literature was reviewed to provide supporting evidence for the mechanism and clinical implications of the drug interaction. Based on this report and previous case reports, caution is advised when concurrent warfarin and 5-fluorouracil are prescribed. In addition, patients should be closely monitored for a possible delayed interaction that may occur with each repeated cycle of 5-fluorouracil chemotherapy.

Topics: Adenocarcinoma; Anticoagulants; Antimetabolites, Antineoplastic; Colonic Neoplasms; Drug Synergism; Female; Fluorouracil; Humans; International Normalized Ratio; Middle Aged; Warfarin

To report a case of concomitant warfarin therapy with consecutive cycles of capecitabine therapy, providing time of onset, magnitude, and assessment of the interaction.. A 59-year-old man receiving chronic warfarin therapy for a mechanical mitral valve replacement was diagnosed with stage IV metastatic colon cancer. He was started on capecitabine/irinotecan after his cancer progressed with fluorouracil/leucovorin and the FOLFOX 6 regimen (oxaliplatin, leucovorin, and continuous fluorouracil infusion). He received 3 consecutive cycles of capecitabine/irinotecan with concomitant oral anticoagulation and, with each cycle, the warfarin dose was reduced. Over the course of these 3 cycles, the total weekly dose of warfarin was reduced by >85%.. The capecitabine-warfarin interaction is clinically significant, requiring a black box warning in the package insert. The mechanism of action for the interaction is not clear, but may be related to down-regulation of CYP2C9 by capecitabine or its metabolites or a pharmacodynamic interaction with warfarin. A common response to this interaction, as discussed in previously published case reports, is the discontinuation of warfarin, capecitabine, or both. In this case, the Naranjo probability scale indicates a highly probable drug interaction between warfarin and capecitabine.. As more patients require anticoagulation, and as chemotherapy agents such as capecitabine become available, the likelihood for these drug interactions increases. In our patient, close monitoring of therapy allowed successful use of warfarin and capecitabine.

Topics: Anticoagulants; Antimetabolites, Antineoplastic; Capecitabine; Colonic Neoplasms; Deoxycytidine; Drug Interactions; Fluorouracil; Heart Valve Prosthesis Implantation; Humans; International Normalized Ratio; Male; Middle Aged; Mitral Valve; Warfarin

Warfarin and aspirin are commonly used to prevent cardiovascular diseases. Aspirin was recently found to have chemopreventive effects on colon cancer and polyps by inhibiting cyclooxygenase-2. Therefore, we evaluated whether the symptoms of bleeding related with aspirin or warfarin could be a clue in early detection of colon cancer. We also assessed the effect of aspirin on the development of synchronous polyps.. A total of forty-one and 16 patients diagnosed as colon cancer, taking aspirin or warfarin respectively were enrolled. In addition, 171 patients with colon cancers were age and gender matched as a control group. We investigated the difference of clinical features and laboratory findings among three groups.. The incidence of bleeding was 81.3% (warfarin), 53.7% (aspirin), 40.4% (control). Among three groups, location and size of cancer, number of lymph nodes involvement and stages were not different, but the number of patients in Duke stage D in warfarin group (n=1, 6.3%) were less than that of the control (n=44, 25.7%) (p=0.049). The extent of circumferential involvement by cancer was lower in aspirin group (67%) than in the control group (80%) (p=0.035). The percentage of patients with synchronous polyps and mean number of synchronous polyps in aspirin group (34.1%, 0.68, respectively) was lower than that of control group (53.6%, 1.69, respectively) (p=0.029, 0.008, respectively).. Bleeding related with aspirin or warfarin usage had no effect on the early diagnosis of colon cancer. However, lower incidence of Duke stage D in warfarin group might be related to anti-metastatic effect of warfarin. In addition, aspirin may have a role in suppressing the development of synchronous polyps.

Topics: Aged; Anticoagulants; Aspirin; Cardiovascular Diseases; Colonic Neoplasms; Female; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Platelet Aggregation Inhibitors; Warfarin

Topics: Blue Toe Syndrome; Catheterization, Central Venous; Colonic Neoplasms; Embolism, Cholesterol; Female; Humans; Middle Aged; Pulmonary Embolism; Thrombosis; Warfarin

Topics: Adult; Aged; Anticoagulants; Antineoplastic Combined Chemotherapy Protocols; Colonic Neoplasms; Drug Therapy, Combination; Female; Fluorouracil; Humans; Incidence; International Normalized Ratio; Leucovorin; Liver Neoplasms; Male; Middle Aged; Organoplatinum Compounds; Prothrombin Time; Rectal Neoplasms; Warfarin

A 62-year-old Caucasian man with atrial fibrillation who was taking warfarin reported an episode of hematochezia; his international normalized ratio (INR) was 1.74. His weekly warfarin dose was increased by approximately 5%, and he was given three fecal occult blood cards. At follow-up 1 week later, the patient denied any episodes of hematochezia. His INR was 1.69 despite the increased warfarin dosage. One of the occult blood cards showed a positive result, and colonoscopy revealed a 5-cm lesion, identified as Dukes' A adenocarcinoma. Warfarin-associated bleeding generally is considered deleterious; however, in our patient it unmasked an early stage of colon cancer and thus may have saved the patient's life. Although minor gastrointestinal bleeding is common among patients taking anticoagulants, all patients should be fully evaluated because the source of hemorrhage may be malignant.

Topics: Atrial Fibrillation; Colonic Neoplasms; Hemorrhage; Humans; Male; Middle Aged; Occult Blood; Warfarin

Topics: Aged; Anticoagulants; Blood Loss, Surgical; Colonic Neoplasms; Emergencies; Heart Valve Prosthesis; Humans; Male; Postoperative Period; Warfarin

Warfarin is commonly used in the prophylaxis or treatment of thromboembolic disease. Haemorrhage is a recognised complication which may be life-threatening. This paper describes eight cases in which lower gastrointestinal bleeding while on warfarin therapy resulted in the discovery of previously unrecognised large bowel malignancy. Diagnosis of an otherwise asymptomatic carcinoma in this way enabled surgery to be carried out at an earlier stage and so may have resulted in a better prognosis for these patients. Bleeding while on anticoagulant therapy is caused by a specific organic lesion in 30% to 50% of cases. This may be the case even when the prothrombin time is very prolonged. It is important, therefore, that such cases are fully investigated, especially in the elderly.

Topics: Aged; Anticoagulants; Cecal Neoplasms; Colonic Neoplasms; Gastrointestinal Hemorrhage; Humans; Warfarin

The increased mortality of emergency vs. elective colonic surgery applies equally to the right and left colon. Recent interest has surrounded the application of expandable metal stenting in acute obstruction but has been confined to the left colon. We describe successful application of stenting in the right colon, allowing postponement of a particularly high-risk laparotomy.. A patient with acute bilateral iliofemoral thromboses simultaneously developed complete obstruction of the proximal transverse colon. After heparinization and under fluoroscopic control, a 10-cm-long, self-expanding Wall-stent (Schneider, Bulach, Switzerland), 22 mm in diameter, was manipulated across the obstruction.. Immediate decompression with symptomatic relief ensued. The stent prevented obstruction during a 10-week period of anticoagulation, and repeat duplex scanning showed resolution of iliac thrombus. An elective right hemicolectomy was then performed. Postoperative course was uncomplicated, and histopathology confirmed a Dukes B carcinoma.. This case, in which a potentially hazardous laparotomy was delayed until the operative risk improved, defines a new role for stenting in colonic obstruction and demonstrates an extension of its applicability to the right colon. Literature review found no other report of stent application in the right colon.

Topics: Acute Disease; Adenocarcinoma; Aged; Anticoagulants; Colonic Neoplasms; Contraindications; Elective Surgical Procedures; Humans; Intestinal Obstruction; Laparotomy; Male; Stents; Thrombophlebitis; Warfarin

To report a possible drug interaction between the combination of fluorouracil (5-FU), levamisole, and warfarin.. An elderly patient with chronic atrial fibrillation and prosthetic valve replacements had been taking warfarin 22.5 mg/wk. Following the diagnosis of colon cancer (Duke's classification D), a chemotherapy regimen of 5-FU and levamisole was started. Within four weeks after initiation of chemotherapy, the International Normalization Ratio (INR) increased from 3.04 to 39.56. Warfarin was discontinued and restarted at 7.5 mg/wk. Discontinuation of levamisole and 5-FU for a five-week period resulted in the INR falling to a subtherapeutic level. Reinstitution of the chemotherapeutic regimen once again led to an increase in INR.. A literature search showed no reports of an interaction between warfarin and levamisole. However, prolongation of 5-FU half-life and an increase in INR have been reported with the concurrent use of 5-FU and warfarin. Inhibition of the hepatic metabolism of warfarin by 5-FU and levamisole is the postulated mechanism of this drug interaction.. This case describes the clinically significant increase of INR in an elderly patient after adding a chemotherapy regimen of levamisole and 5-FU to a previous regimen of warfarin alone. The increasing incidence of both atrial fibrillation and colon cancer with age could potentially require the concomitant use of 5-FU, levamisole, and warfarin. Because of the potential severity of this interaction, close monitoring of INR and warfarin dosage adjustment is recommended in patients receiving warfarin along with levamisole and 5-FU.

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Colonic Neoplasms; Drug Interactions; Fluorouracil; Humans; Levamisole; Male; Warfarin

Hypothetical clinical cases were used to investigate transfusion-related decision-making. Three red cell, three fresh frozen plasma (FFP) and three albumin transfusion decision cases were administered by questionnaire to 228 medical staff. The transfusion decision triggers were identified and comparisons made between resident and specialist groups and between Melbourne and Sydney participants. Factors important in red cell transfusion decisions included haemoglobin, symptoms of anaemia, presence of co-morbidities or surgery, gender, period of hospitalisation and the degree of documented blood loss. FFP administration was influenced by an abnormal coagulation test, the presence of co-morbidities and by the number of red cell units transfused. The administration of albumin, concentrated or 5% SPPS, was influenced by the period of hospitalisation and clinical circumstances such as a falling urine output postoperatively, and by the presence of hypotensive complications. Different transfusion responses were noted: resident staff transfused red cells and FFP earlier than specialists; Sydney specialists were more conservative of red cell transfusion; Melbourne specialists more conservative of FFP administration and surgeons were four times more likely to transfuse patients than physicians or anesthetists at certain haemoglobin values.

Topics: Abruptio Placentae; Adult; Aged; Ascites; Blood Component Transfusion; Blood Loss, Surgical; Blood Transfusion; Cesarean Section; Colonic Neoplasms; Decision Making; Disseminated Intravascular Coagulation; Epistaxis; Female; Humans; Hypoproteinemia; Male; Medical Staff, Hospital; Middle Aged; Peptic Ulcer Hemorrhage; Plasma; Pregnancy; Serum Albumin; Sex Factors; Warfarin; Wounds and Injuries

Topics: Adenocarcinoma; Aged; Colonic Neoplasms; Drug Interactions; Fluorouracil; Humans; Male; Warfarin

Anticoagulant drugs are known to have an effect on tumour growth. However, the mechanisms by which they act are poorly understood, and have therefore been investigated in this study. Wistar rats were given eight weekly subcutaneous injections of azoxymethane, at a dose of 10 mg kg-1 week-1. Following this they were randomized into two groups: a control group, which received no further treatment, and a warfarin treated group, which received warfarin at 'non-therapeutic' doses in their drinking water, for a further 8 weeks. Pairs of rats from each group were killed at 5-weekly intervals from 10 to 35 weeks after the first azoxymethane injection. At 40 weeks all remaining rats were killed. Samples of colonic mucosa from the descending colon and rectum were taken for scanning electron microscopy. The number of microadenomas per low power field was determined in both groups at each time interval. Tumour incidence and distribution were noted in animals killed at 40 weeks. The median number of microadenomas was significantly lower in warfarin treated animals than in controls at all time intervals. Tumour number was also significantly decreased by warfarin treatment (27 in azoxymethane treated animals, 10 in animals receiving azoxymethane and warfarin, P less than 0.05). The distribution of tumours along the colon was similar to that seen previously, following 12 weeks of azoxymethane. These effects occurred despite the non-concurrent administration of azoxymethane and warfarin.

Topics: Adenoma; Animals; Azoxymethane; Colon; Colonic Neoplasms; Disease Models, Animal; Intestinal Mucosa; Male; Microscopy, Electron, Scanning; Precancerous Conditions; Random Allocation; Rats; Rats, Inbred Strains; Rectal Neoplasms; Rectum; Warfarin

The effect of low dose warfarin and high dose warfarin on epithelial cell kinetics (as determined by stathmokinetic techniques), and preneoplastic morphological changes was studied during azoxymethane induced carcinogenesis in the rat. Warfarin, at either low or high dose, had no effect on crypt cell production rate (CCPR) at any time interval whereas tumour incidence in both low dose warfarin and high dose warfarin groups was significantly reduced. Morphological changes were observed using scanning electron microscopy, which by conventional histology were shown to be adenoma precursors. In the control group the number of microadenomas increased with time after starting azoxymethane. In warfarin treated animals, the number of microadenomas also increased with time, but the actual incidence was reduced when compared with controls. These results suggest that the effects of warfarin on tumour development is unrelated to its anticoagulant effect, because increased dose did not result in greater tumour reduction. Furthermore, there was no overall change in CCPR when warfarin was administered. Warfarin may exert a specific effect, by preventing neoplastic change in cells which have undergone morphologically undetectable changes associated with early carcinogenesis.

Topics: Adenoma; Animals; Azoxymethane; Cell Cycle; Colon; Colonic Neoplasms; Epithelium; Male; Microscopy, Electron, Scanning; Rats; Rats, Inbred Strains; Rectal Neoplasms; Rectum; Warfarin

Topics: Aged; Colonic Neoplasms; Female; Gastrointestinal Hemorrhage; Humans; Middle Aged; Rectum; Warfarin

Topics: Animals; Colonic Neoplasms; Liver Neoplasms; Lung Neoplasms; Male; Neoplasm Metastasis; Neoplasms, Experimental; Rats; Rats, Inbred Strains; Rectal Neoplasms; Warfarin

Twenty-five patients with advanced measurable adenocarcinoma of the colon were treated with 5-fluorouracil (FUra), 15 to 20 mg/kg/week i.v., plus warfarin p.o. at a dosage which maintains therapeutic levels of anticoagulation. Sixty-four % of patients achieved either objective response (20%) or stable disease (44%). Overall median survival was 19.2 months. Three patients (all with intraluminal lesions) developed gastrointestinal blood loss requiring transfusion and discontinuation of anticoagulation. The interaction between warfarin and FUra as measured by plasma levels was investigated in seven rabbits and three patients. Plasma samples were obtained for 2 hr after FUra administration, both before and after anticoagulation with warfarin. FUra was measured by gas chromatography, and warfarin was assayed using a thin-layer chromatographic fluorescence method. In rabbits, prolongation of FUra plasma t1/2 was seen with high (0.6 mg/kg/hr) but not low (0.025 mg/kg/hr) rates of warfarin infusion. In patients, FUra t1/2 was not changed by therapeutic warfarin anticoagulation. Thus, (a) plasma clearance interaction between FUra and warfarin does not occur in patients receiving therapeutic levels of anticoagulation; (b) FUra and warfarin anticoagulation can be safely given and frequently result in stable disease status for patients with advanced colon cancer. Further trials of this combination are warranted in adenocarcinoma of the colon.

Topics: Adenocarcinoma; Animals; Colonic Neoplasms; Drug Therapy, Combination; Fluorouracil; Humans; Kinetics; Rabbits; Warfarin

Topics: Agranulocytosis; Anus Diseases; Anus Neoplasms; Blood Coagulation Disorders; Blood Platelet Disorders; Blood Platelets; Blood Transfusion; Colitis, Ulcerative; Colonic Diseases; Colonic Neoplasms; Factor V Deficiency; Factor VII Deficiency; Gastrointestinal Hemorrhage; Hemophilia A; Humans; Hypoprothrombinemias; Liver Diseases; Lymphoma; Rectal Diseases; Warfarin

Topics: Adenocarcinoma, Papillary; Blood Coagulation Tests; Blood Platelet Disorders; Blood Transfusion; Chromium Isotopes; Colectomy; Colonic Neoplasms; Gastrointestinal Hemorrhage; Hematoma; Humans; Male; Middle Aged; Postoperative Complications; Staphylococcus; Thrombocytopenia; Thrombophlebitis; Warfarin

Topics: Afibrinogenemia; Blood Coagulation Tests; Colonic Neoplasms; Deoxyribonuclease I; Disseminated Intravascular Coagulation; Drug Therapy; Enzyme Inhibitors; Factor V; Factor VIII; Fibrinolysis; Heparin; Humans; Immunoelectrophoresis; Plasminogen; Streptodornase and Streptokinase; Streptokinase; Warfarin