Thrombosis and cancer: 40 years of research.

We have taken here the task to go back to a brief history concerning the evolution of the concept of "cancer and thrombosis" according to the experience accumulated by our group in the last 40years. Since its first description by Armand Trousseau in 1865, the association between cancer and thrombosis only received attention again during the last decades of the XXth century: from scattered reports on experimental material (tumor extracts) or on animal models of tumor/metastasis growth, through the progress of cell biology and experimental pharmacology, the interest moved to clinical questions, such as: how to prevent and treat thrombosis, a frequent complication of both solid and hematologic malignancies? Has an occult cancer to be suspected in the majority of cases of idiopathic deep vein thrombosis? Do we need to prevent pharmacologically the occurrence of chemotherapy-associated thrombosis? Do anticoagulants have an impact on the natural history of some tumors? Why antiangiogenetic agents may be associated to a thrombotic risk? Presently, a continuous cross-talk between clinical results and experimental data is required to provide answers to these questions, taking advantage from a multidisciplinary approach to this still partially mysterious issue. If one would take a paradigm of the evolution of the subject during the past 40years, a symbol could be the knowledge accumulated on tissue factor, the "middleman" of the clotting cascade as well as of the interactions between thrombosis and cancer, as briefly reviewed at the end of this chapter.