ABSTRACT
The association between human cancer and the clotting system has been recognized for more than a century, even if many aspects of this interaction still await clarification. This association has been evaluated from two viewpoints and with a dual meaning: on one hand, significant hemostatic abnormalities and thrombotic and hemorragic complications have been observed in cancer patients; hemostatic complications are indeed a common cause of death in cancer patients; among the underlying mechanisms, many tumor cells possess strong procoagulant activities that promote the local activation of the coagulation system (for a review, see Donati and Falanga1); on the other hand, tumor-mediated activation of the coagulation cascade has been implicated in both the formation of tumor stroma and the promotion of hematogenous metastases.
