Alok A Khorana1, Deborah Rubens2, Charles W Francis3. 1. Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH, USA. Electronic address: Khorana@ccf.org. 2. Department of Radiology, University of Rochester, Rochester, NY, USA. 3. James P. Wilmot Cancer Center, University of Rochester, Rochester, NY, USA; Department of Medicine, University of Rochester, Rochester, NY, USA.
Abstract
BACKGROUND: The utility of screening for venous thromboembolism (VTE) in cancer patients is unknown. We evaluated this in a prospective cohort study of cancer patients initiating a new chemotherapy regimen and deemed high-risk (score ≥3) based on a validated Risk Score. METHODS: Patients were evaluated with baseline and Q4 (±1) week serial ultrasonography for up to 16 weeks; additionally, computed tomography scans for restaging were also evaluated for VTE. RESULTS: The study population comprised 35 patients. Pancreatic and gastro-esophageal cancers were the most common diagnoses. Of these, 8 (23%) developed a VTE. This included 5 patients with DVT alone (14%), 1 patient with PE alone (3%) and 2 (6%) with both. Ultrasound examinations identified asymptomatic DVT in 9.3% of patients at baseline; 0% at weeks 4 and 8 and 5.6% at week 12. Restaging CT scans identified asymptomatic PE in one patient at week 6 and in one patient at week 9 with subsequent DVT at week 10. CONCLUSIONS: Screening for asymptomatic VTE has not been previously used as a clinical strategy in ambulatory cancer patients. We report that one-tenth of patients at baseline had occult DVT and in this high-risk population, screening at baseline may be of value.
BACKGROUND: The utility of screening for venous thromboembolism (VTE) in cancerpatients is unknown. We evaluated this in a prospective cohort study of cancerpatients initiating a new chemotherapy regimen and deemed high-risk (score ≥3) based on a validated Risk Score. METHODS:Patients were evaluated with baseline and Q4 (±1) week serial ultrasonography for up to 16 weeks; additionally, computed tomography scans for restaging were also evaluated for VTE. RESULTS: The study population comprised 35 patients. Pancreatic and gastro-esophageal cancers were the most common diagnoses. Of these, 8 (23%) developed a VTE. This included 5 patients with DVT alone (14%), 1 patient with PE alone (3%) and 2 (6%) with both. Ultrasound examinations identified asymptomatic DVT in 9.3% of patients at baseline; 0% at weeks 4 and 8 and 5.6% at week 12. Restaging CT scans identified asymptomatic PE in one patient at week 6 and in one patient at week 9 with subsequent DVT at week 10. CONCLUSIONS: Screening for asymptomatic VTE has not been previously used as a clinical strategy in ambulatory cancerpatients. We report that one-tenth of patients at baseline had occult DVT and in this high-risk population, screening at baseline may be of value.
Authors: Peter J Lawson; Hunter B Moore; Ernest E Moore; Mark E Gerich; Gregory R Stettler; Anirban Banerjee; Richard D Schulick; Trevor L Nydam Journal: J Surg Res Date: 2018-06-08 Impact factor: 2.192
Authors: Gary H Lyman; Marc Carrier; Cihan Ay; Marcello Di Nisio; Lisa K Hicks; Alok A Khorana; Andrew D Leavitt; Agnes Y Y Lee; Fergus Macbeth; Rebecca L Morgan; Simon Noble; Elizabeth A Sexton; David Stenehjem; Wojtek Wiercioch; Lara A Kahale; Pablo Alonso-Coello Journal: Blood Adv Date: 2021-02-23
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Authors: Frits I Mulder; Matteo Candeloro; Pieter W Kamphuisen; Marcello Di Nisio; Patrick M Bossuyt; Noori Guman; Kirsten Smit; Harry R Büller; Nick van Es Journal: Haematologica Date: 2019-01-03 Impact factor: 11.047