Angiogenesis and hemostasis in colorectal cancer

Worldwide, colorectal cancer is the third cause of death in men and the second cause of death in women, with nearly 1.2 million newly-diagnosed cases and 600,000 estimated deaths. A significant proportion of patients have metastatic disease at diagnosis. Neoangiogenesis is the formation of new blood vessels from those already existing, which play an important role in tumor growth and progression. Factors related to endothelial growth have been identified including vascular endothelial growth factor. Different studies have demonstrated coagulation and fibrinolysis systems activation participation in tumor angiogenic development. Some of these factors are Von Willebrand factor, fibrinogen, type I plasminogen activator inhibitor and receptor, in addition to D-dimer and platelets. Serum concentrations of these proteins are considered to be predictors of treatment response, disease progression and survival. Interaction between tumor cells, angiogenesis and coagulation activation is a positive feedback, and strategies interfering in this relationship, such as the use of chemotherapy in combination with new specifically targeted agents, can prevent or treat cancer. In addition, the role of anticoagulant or antiplatelet agents in the treatment of cancer has not yet been determined.