Risk factors of recurrence in patients with cancer-associated venous thromboembolism

2021 ◽  
Author(s):  
Yuji Nishimoto ◽  
Yugo Yamashita ◽  
Takeshi Morimoto ◽  
Yukihito Sato ◽  
Takeshi Kimura
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Patients With Cancer

Thrombosis and Cancer: Emerging Data for the Practicing Oncologist

2013 ◽  
pp. e337-e345 ◽  
Author(s):  
Gary H. Lyman ◽  
Alok A. Khorana ◽  
Anna Falanga
Keyword(s):  
Risk Factors ◽  
Clinical Practice ◽  
Venous Thromboembolism ◽  
Practice Guidelines ◽  
Malignant Disease ◽  
Patients With Cancer ◽  
Treatment And Prevention ◽  
Close Relationship ◽  
Specific Factors ◽  
American Society

The American Society of Clinical Oncology (ASCO) recently updated clinical practice guidelines on the treatment and prevention of venous thromboembolism (VTE) in patients with cancer. Although several new studies have been reported, many questions remain about the close relationship between VTE and malignant disease. The risk of VTE among patients with cancer continues to increase and is clearly linked to patient-, disease- and treatment-specific factors. In general, VTE among patients with cancer is treated in a similar fashion to that in other patient populations. However, the greater risk of VTE in patients with cancer, the multitude of risk factors, and the greater risk of VTE recurrence and mortality among patients with cancer pose important challenges for surgeons, oncologists, and other providers.

Review of the Relationship Between Venous Thromboembolism, Malignancy and Its Treatment

2008 ◽  
Vol 21 (2) ◽  
pp. 126-137 ◽  
Author(s):  
Erika N. Brown ◽  
Jon D. Herrington
Keyword(s):  
Risk Factors ◽  
Growth Factors ◽  
Venous Thromboembolism ◽  
Thrombotic Event ◽  
Common Complication ◽  
Hematopoietic Growth Factors ◽  
Intravascular Coagulation ◽  
Patients With Cancer ◽  
Chemotherapy Agents ◽  
The Relationship

Venous thromboembolism is a common complication that develops in approximately 20% of patients with cancer. Presence of tumor and other risk factors, such as inflammation, surgery, obesity, and medications, have the potential to alter the intravascular coagulation homeostasis and lead to thrombosis. Although malignancy may predispose patients to venous thromboembolism, many chemotherapy agents also increase the risk. In this article, some of the agents tamoxifen, asparaginase, fluorouracil, thalidomide, lenalidomide, bevacizumab, and hematopoietic growth factors are discussed. Many patients will experience a thrombotic event despite optimal prophylaxis. Thus, this article will address the guidelines for treatment and prophylaxis of venous thromboembolism. In general, the venous thromboembolism risk should be assessed before certain antineoplastic regimens are prescribed to patients with cancer.

Epidemiology, risk and outcomes of venous thromboembolism in cancer

2012 ◽  
Vol 32 (02) ◽  
pp. 115-125 ◽  
Author(s):  
L. Russo ◽  
A. Falanga
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Brain Cancer ◽  
Prediction Models ◽  
Disease Stage ◽  
Individual Factors ◽  
Scientific Societies ◽  
Risk Prediction Models ◽  
Patients With Cancer ◽  
Increased Risk

SummaryCancer is associated with a fourfold increased risk of venous thromboembolism (VTE). The risk of VTE varies according to the type of malignancy (i. e. pancreatic cancer, brain cancer, lymphoma) and its disease stage and individual factors (i. e. sex, race, age, previous VTE history, immobilization, obesity). Preventing cancer-associated VTE is important because it represents a significant cause of morbidity and mortality. In order to identify cancer patient at particularly high risk, who need thromboprophylaxis, risk prediction models have become available and are under validation. These models include clinical risk factors, but also begin to incorporate biological markers. The major American and European scientific societies have issued their recommendations to guide the management of VTE in patients with cancer.In this review the principal aspects of epidemiology, risk factors and outcome of cancer-associated VTE are summarized.

scholarly journals Assessing Risk of Venous Thromboembolism in the Patient With Cancer

2009 ◽  
Vol 27 (29) ◽  
pp. 4839-4847 ◽  
Author(s):  
Alok A. Khorana ◽  
Gregory C. Connolly
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Venous Thromboembolism ◽  
Initial Period ◽  
Antiangiogenic Therapy ◽  
Clinical Risk Factors ◽  
Treatment Modalities ◽  
Primary Tumor Site ◽  
Patients With Cancer ◽  
Clinical Risk

PurposePatients with cancer are increasingly at risk for venous thromboembolism (VTE). Rates of VTE, however, vary markedly among patients with cancer.DesignThis review focuses on recent data derived from population-based, hospital-based, and outpatient cohort studies of patients with cancer that have identified multiple clinical risk factors as well as candidate laboratory biomarkers predictive of VTE.ResultsClinical risk factors for cancer-associated VTE include primary tumor site, stage, initial period after diagnosis, presence and number of comorbidities, and treatment modalities including systemic chemotherapy, antiangiogenic therapy, and hospitalization. Candidate predictive biomarkers include elevated platelet or leukocyte counts, tissue factor, soluble P-selectin, and D-dimer. A recently validated risk model, incorporating some of these factors, can help differentiate patients at high or low risk for developing VTE while receiving chemotherapy.ConclusionIdentifying patients with cancer who are most at risk for VTE is essential to better target thromboprophylaxis, with the eventual goal of reducing the burden as well as the consequences of VTE for patients with cancer.

Assessment of Clinical Risk Factors for Symptomatic Venous Thromboembolism in Common Cancers: A VERITY Registry Study

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3826-3826
Author(s):  
Shankaranarayana Paneesha ◽  
Aidan McManus ◽  
Roopen Arya ◽  
Nicholas Scriven ◽  
Tim Nokes ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Risk Factor ◽  
Venous Thromboembolism ◽  
Family History ◽  
Cancer History ◽  
Patients With Cancer ◽  
Thrombosis Risk ◽  
History Of ◽  
Age And Sex

Abstract The association between venous thromboembolism (VTE) and cancer is well-recognised, but the thrombosis risk factor profile of patients with cancer-associated VTE is poorly characterised; it is unclear if additional risk factors contribute to the risk of thrombosis beyond the cancer itself, or if the risk factor profile is tumour-specific. Our aim was to compare the thrombosis risk factor profiles of cancer patients with or without symptomatic VTE enrolled in VERITY, an ongoing UK prospective VTE registry. The VERITY registry records data on patients with VTE and those in whom the diagnosis of VTE is excluded. Between Jun 05 and Mar 08, 49044 patient entries were made. Individual case data for patients with cancer were extracted. Using available risk factor data, univariate analysis of 9 established risk factors for VTE (medical in-patient history/immobilisation >3 days within last 4 weeks; major surgery in the last 4 weeks; hormonal risk factor; previous history of VTE; family history of VTE; known thrombophilia; intravenous drug abuse; current smoking; and leg paralysis), comparing VTE and non-VTE cancer cases, was performed for the 4 most common cancers using SPSS. To account for the potential impact of age and sex on VTE risk, age-adjusted values were calculated for breast and prostate cancer, and age- and sex-adjusted values for colorectal and lung. A nominal level of 5% statistical significance was assumed. Of 2825 cancer cases, 1382 had an objectively confirmed diagnosis of VTE and in 1443 the diagnosis of VTE was excluded. Breast (n=498), prostate (n=374), colorectal (n=343) and lung cancer (n=275) accounted for 53% of cancer cases. Univariate associations between risk factors and symptomatic VTE were found only for prostate cancer: history of VTE (odds ratio [OR] = 3.48; 95% CI, 2.01, 6.02; p < 0.00001), family history of VTE (OR = 2.56; 95% CI, 1.02, 6.44; p = 0.046), hormonal risk factor (OR = 2.22; 95% CI, 1.00, 4.92; p = 0.049). In colorectal cancer, smoking was less likely in VTE cases (OR = 0.54; 95% CI, 0.34, 0.87; p = 0.012). Adjusting for age (and sex), univariate associations between risk factors and symptomatic VTE were again found only for prostate cancer: history of VTE (OR = 3.23; 95% CI, 1.56, 6.68; p = 0.002), with smoking less likely in age-adjusted VTE cases (OR = 0.50; 95% CI, 0.28, 0.91; p = 0.022). Our analysis of a registry population found few associations between known thrombosis risk factors and symptomatic VTE in patients with common cancers, suggesting these factors impact little on thromboembolic risk in these cancers.

scholarly journals Cancer-associated thrombosis: the when, how and why

2019 ◽  
Vol 28 (151) ◽  
pp. 180119 ◽  
Author(s):  
Caio J. Fernandes ◽  
Luciana T. K. Morinaga ◽  
José L. Alves ◽  
Marcela A. Castro ◽  
Daniela Calderaro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
General Population ◽  
Cause Of Death ◽  
Annual Incidence ◽  
Patients With Cancer ◽  
Cause Of Deaths ◽  
Cancer Associated Thrombosis ◽  
Active Cancer

Cancer-associated thrombosis (CAT) is a condition in which relevance has been increasingly recognised both for physicians that deal with venous thromboembolism (VTE) and for oncologists. It is currently estimated that the annual incidence of VTE in patients with cancer is 0.5% compared to 0.1% in the general population. Active cancer accounts for 20% of the overall incidence of VTE. Of note, VTE is the second most prevalent cause of death in cancer, second only to the progression of the disease, and cancer is the most prevalent cause of deaths in VTE patients. Nevertheless, CAT presents several peculiarities that distinguish it from other VTE, both in pathophysiology mechanisms, risk factors and especially in treatment, which need to be considered. CAT data will be reviewed in this review.

Predictors Of Vena Cava Filter Use For Venous Thromboembolism In Cancer Patients

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 935-935
Author(s):  
Gwendolyn Ho ◽  
Ann Brunson ◽  
Richard H. White ◽  
Ted Wun
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Cancer Patients ◽  
Brain Cancer ◽  
Vena Cava ◽  
Severity Of Illness ◽  
Bleeding Risk ◽  
Factors Associated ◽  
Patients With Cancer ◽  
Cancer Types

Abstract Background The use of vena cava filters (VCF) in the treatment of venous thromboembolism (VTE) is controversial. Few studies have evaluated the use of VCFs in cancer patients with acute thrombosis. Aims To determine frequency of VCF placement and factors associated with VCF use in patients with cancer hospitalized for acute VTE, and to compare these findings to patients without cancer hospitalized for acute VTE. Methods Using a retrospective observational study design, we analyzed hospital discharge records in California from 2005-2009 of cases presenting with acute VTE. Patients with cancer were identified by specific ICD-9-CM codes for the index VTE admission or a cancer diagnosis within 6 months prior to the index VTE. Bivariate and multivariable logistic regression analyses were used to determine predictive factors for placement of a VCF in cancer patients. Candidate risk factors included basic demographic parameters, cancer type, severity-of-illness (SOI) on admission, undergoing surgery, bleeding, and hospital characteristics. Results A VCF was placed in 19.6% of 14,000 cancer cases admitted with a principal diagnosis of acute VTE, versus 10.8% of 70,472 non-cancer cases admitted during the same time period. Among cancer cases, there was little variation in percentage that received a VCF based on age, and no significant variation across race or insurance type, except that self pay cancer patients had a lower rate of VCF placement. Variation across hospitals in the percentage of cancer cases that received a VCF was striking, ranging from 0% to 52% among hospitals that admitted a minimum of 15 acute VTE cases. There was a strong correlation (r=0.72, R2=0.52) in the frequency of VCF placement in cancer and non-cancer cases within individual hospitals. Among cancer types, the frequency of VCF placement was highest in cases with brain cancer (43%), with the observed frequency of VCF use among other cancer types ranging from 8%-23%. Patients with brain cancers, which has a high perceived bleeding risk were over 4 fold more likely to have a VCF placed compared to those cancers with low bleeding risk. Having acute leukemia did not predict for VCF placement. Only 8.2% of cancer patients had a strict contraindication to anticoagulation (acute bleeding or recent/imminent surgery), which are the only guideline-based indications for VCF placement. Active bleeding and undergoing surgery were each strongly associated with VCF use: 47% of cases that bled and 58% of cases who underwent surgery had a VCF placed. Results of the multivariable logistic model are shown in the table. In addition to bleeding and undergoing surgery, factors associated with VCF insertion included: larger hospital, urban location, private hospital and greater SOI at the time of admission. Conclusions The frequency of VCF use in cancer patients admitted for acute VTE is much higher than in non-cancer patients. Major risk factors for VCF use include bleeding, undergoing recent surgery, having brain cancer, urban location, and greater severity of illness. The frequency of VCF placement among cancer patients varied widely across hospitals. Given the extraordinary variation in the frequency of use of VCFs between hospitals, more research is needed to better define outcomes of VCF placement in cancer patients. Disclosures: Ho: American Society of Hematology: ASH HONORS trainee research award Other.

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