Hypercoagulation in Lung Cancer

Annisa Dian Harlivasari, Elisna Syahruddin


Hypercoagulation with a clinical manifestation of Venous Thromboembolism (VTE) is a frequent complication of malignancy whose incidence has increased markedly these recent years. The occurrence of VTE is likely to be triggered by multiple pathways dominated by tissue factor (TF). The VTE itself can directly lead to patient mortality and becoming the cause of death in cancer patients. Furthermore, emerging data suggest that activation of coagulation in malignancy is integrally linked with tumor biology, host associated and cancer treatment particularly with anti-angiogenesis. The clinical hypercoagulable state is linked with prognosis in patients with lung cancer, including patients receiving systemic chemotherapy. (J Respir Indo 2019; 39(2): 130-9)


Hypercoagulation, lung cancer, tissue factor (TF), venous thromboembolism (VTE), malignancy.

Full Text:



Lee AY. Cancer and thromboembolic disease: pathogenic mechanisms. Cancer Treat Rev. 2002;28:137–40.

Elyamany G, Alzahrani AM, Bukhary E. Cancer- associated thrombosis: an overview. Clin Med Insights Oncol. 2014;8:129–37

Sato T, Tsujino I, Ikeda D, Ieko M, Nishimura M. Trousseau’s syndrome associated with tissue factor produced by pulmonary adenocarcinoma. Tho- rax. 2006;61(11):1009-10.

Caine GJ, Stonelakey PS, Lip GYH, Sean T. The hypercoagulable state of malignancy: pathogene- sis and current debate. Neoplasia. 2002;4(6):465-73.

Vitale C, D’Amato M, Calabrò P, Stanziola AA, Mormile M, Molino A. Venous thromboembolism and lung cancer: a review. Multidiscip Respir Med. 2015;10:28.

Kyriazi V, Theodoulou T. Assessing the risk and prognosis of thrombotic complications in cancer patients. Arch Pathol Lab Med. 2013;137:1286–95.

Blom JW, Vanderschoot JPM, Oostindie¨ r MJ, Osanto S, van der Meer FJM, Rosendaal FR. Incidence of venous thrombosis in a large cohort of 66.329 cancer patients: results of a record linkage study. J Thromb Haemost. 2006:4;529–35.

Kadlec B, Skrickova J, Merta Z, Dusek L, Jar- kovsky J. The incidence and predictors of thromboembolic events in patients with lung cancer. Sci World J. 2014:1-9.

Nichols L, Saunders R, Knollmann FD. Causes of death of patients with lung cancer. Arch Pathol Lab Med. 2012;136:1552–7.

Khorana AA. Venous thromboembolism and prog- nosis in cancer. Thromb Res. 2010:125;490–3.

Lyman GH. Venous thromboembolism in the patient with cancer: focus on burden of disease and benefits of tthromboprophylaxis. Cancer. 2011;117(7): 1334–49.

Palta S, Saroa R, Palta A. Overview of the coagu- lation system. Indian J Anaesth 2014;58:515-23.

White RH. Identifying risk factors for venous thromboembolism. Circulation. 2012;125:2051-3.

Khorana AA, Connolly GC. Assessing risk of ve- nous thromboembolism in the patient with cancer. J Clin Oncol. 2009:27;4839-47.

Karimi M, Cohan N. Cancer-Associated Thrombo- sis. Open Cardiovasc Med J. 2010;4:78-82.

Turpie AG, Esmon C. Venous and arterial throm- bosis pathogenesis and the rationale for anticoagulation.Thromb Haemost 2011;105: 586–96.

Zhou Y-X, Yang Z-M, Feng J, Shan Y-J, Wang W-L, Mei Y-Q: High plasma D-dimer level is associated with decreased survival in patients with lung cancer: a meta-analysis. Tumour Biol 2013;34(6):3701-4.

Lima LG, Monteiro RQ. Activation of blood coagu- lation in cancer implications for tumour progres- sion. Biosci Rep. 2013;33(5):701-10.

Yapijakis C, Bramosi A, Nixon AM, Ragos V, Vai- raktaris E. The interplay between hemostasis and malignancy: the oral cancer paradigm. Anticancer Res. 2012;32: 1791-800.

Caine GJ, Stonelakey PS, Lip GYH, Kehoe ST. The hypercoagulable state of malignancy: pathogenesis and current debate. Neoplasia. 2002;4:465–73.

Yusuf M, Gupta A, Kumar A, Afreen S, Ambreen K, Mishra B. Evaluation of clinical outcome of cancer related thrombophilia: a review. Biomed Res. 2010;21(1):81-86.

Yang Y, Zhou Z, Niu XM, Li ZM, Chen ZW, Jian H, et al. Clinical analysis of postoperative venous thromboembolism risk factors in lung cancer patients. J Surg Oncol. 2012;106(6):736-41.

Sandén, P., Svensson, P.J. & Själander, A. Venous thromboembolism and cancer risk. J Thromb Thrombolysis. 2017;43:68-73.

Eppy, Harsal A, Amin Z, Nainggolan G, Atmakusuma D. Hiperkoagulasi pada pasien kanker paru bukan sel kecil. Maj Kedokt Indon. 2007;57(2):41-6.

Hisada Y, Geddings JE, Ay C, Mackman N. Venous thrombosis and cancer: from mouse models to clinical trials. J Thromb Haemost 2015;13:1372–82.

de Meis E, Pinheiro VR, Zamboni MM, Guedes MT, Castilho IA, Martinez MM, et al. Clotting, immune system, and venous thrombosis in lung adenocar- cinoma patients: a prospective study. Cancer In- vest. 2009;27:989–97.

Chew HK, Davies AM, Wun T, Harvey D, Zhou H, White RH, et al. The incidence of venous thromboembolism among patients with primary lung cancer. J Thromb Haemost. 2008;6(4):601–8.

Connolly GC, Dalal M, Lin J, Khorana AA. Inci- dence and predictors of venous thromboembolism (VTE) among ambulatory patients with lung cancer. Lung Cancer. 2012;78(3):253-8.

Mirshahi S, Pritchard LL, Pocard M, Mirshahi M, Soria J. Pathogenesis and diagnosis of venous hypercoagulable states in cancer. J Hematol Thrombo Dis. 2015;3(3):1-4.

Alok A, Khorana AA, Connolly GC. Assessing risk of venous thromboembolism in the patient with cancer. J Clin Oncol. 2009;27(29):4839-47.

Kurniawan A. Patogenesis, diagnosis dan penatalaksanaan tromboemboli vena pada kanker. Indonesian Journal of Cancer. 2013;7(3): 103-10.

Lyman GH, Khorana AA. Cancer, clots and consensus: new understanding of an old problem. J Clin Oncol. 2009(27);4821-6.

Del Conde I, Bharwani LD, Dietzen DJ, Pendurthi U, Thiagarajan P, López JA. Microvesicle-associ- ated tissue factor and Trousseau’s syndrome. J Thromb Haemost. 2007;5(1)70-4.

Majidiah F, Sjahruddin E, Andarini SL. Trombosis vena dalam pada pasien kanker paru berdasar kriteria wells. J Respir Indo. 2014; 34: 1-10.

Tas F, Kilic L, Serilmez M, Keskin S, Sen F, Duranyildiz D. Clinical and prognostic significance of coagulation assays in lung cancer. Respir Med. 2013;107:451-7.

Lyman GH , Khorana AA, Kuderer NM, Lee AY, Arcelus JI, Balaban EP. Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31(17):2189-2204.

Ikushima S, Ono R, Fukuda K, Sakayori M, Awano N, Kondo K. Trousseau’s syndrome: cancer-associated thrombosis. JJCO. 2016:46(3);204–8.

Lee AY. Management of thrombosis in cancer: pri- mary prevention and secondary prophylaxis. Br J Haematol. 2005;128(3):291-302.

Lyman GH, Khorana AA, Falanga A, Clarke-Pear- son D, Flowers C, Jahanzeb M. American Society of Clinical Oncology guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer. J Clin Oncol. 2007;25.

DOI: https://doi.org/10.36497/jri.v39i2.53


  • There are currently no refbacks.

Copyright (c) 2019 Jurnal Respirologi Indonesia


SINTA Garuda Indonesian Scientific Journal Database (ISJD) Indonesia One Search (IOS) Crossref

ROAD-ISSN Dimensions Google Scholar 


Jurnal Respirologi Indonesia
pISSN: 0853-7704 - eISSN: 2620-3162
Address: Jalan Cipinang Bunder No. 19, Cipinang, Pulogadung, Jakarta Timur, DKI Jakarta 13240, Indonesia
Phone: +62-21-2247-4845
Email: editor@jurnalrespirologi.org

An official publication by
the Indonesian Society of Respirology (ISR)

Creative Commons License
Creative Commons Attribution-NonCommercial 4.0 International License