L Jara-Palomares1, N van Es2, J M Praena-Fernandez3, G Le Gal4, H M Otten5, P Robin6, A Piccioli7, R Lecumberri8, P Religa9, V Rieu10, M Rondina11, M Beckers12, P Prandoni7, P Y Salaun6, M Di Nisio13, P M Bossuyt14, N Kraaijpoel2, H R Büller2, M Carrier15. 1. Medical Surgical Unit of Respiratory Diseases, Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocio Hospital, Sevilla, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. Electronic address: luisoneumo@hotmail.com. 2. Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands. 3. Statistics, Methodology and Research Evaluation Unit, Andalusian Public Foundation for Health Research Management, Hospital Virgen del Rocío, Seville, Spain. 4. Department of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Canada; Département de Médecine Interne et Pneumologie, Centre Hospitalo-Universitaire de Brest, Université de Bretagne Occidentale, Brest, France. 5. Department of Internal Medicine, MC Slotervaart, Amsterdam, the Netherlands. 6. Service de Médecine Nucléaire, Centre Hospitalo-Universitaire de Brest, Université de Bretagne Occidentale, Brest, France. 7. Departments of Cardiovascular Sciences and Medicine, University Hospital of Padua, Padua, Italy. 8. Hematology Service, Clinica Universidad de Navarra, Pamplona, Spain; CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain. 9. Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Medicine, Warsaw Medical University, Warsaw, Poland. 10. Department of Internal Medicine, Centre Hospitalo-Universitaire Estaing, Clermont-Ferrand, France. 11. Department of Internal Medicine and the Molecular Medicine Program, University of Utah, Salt Lake City, UT, USA; George E. Wahlen VAMC GRECC, Salt Lake City, UT, USA. 12. Department of Hematology, University Hospital Leuven, Leuven, Belgium. 13. Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands; Dipartimento di Medicina e Scienze dell'Invecchiamento, Università "Gabriele d'Annunzio", Chieti, Pescara, Italy. 14. Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, Amsterdam, the Netherlands. 15. Department of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Canada.
Abstract
BACKGROUND: Unprovoked venous thromboembolism (VTE) may be the first manifestation of an underlying cancer. We aimed to assess the period prevalence of occult cancer detection stratified by VTE location (deep vein thrombosis [DVT], pulmonary embolism [PE] or both) and the anatomical relationship between occult cancer and VTE. METHODS: Post-hoc analysis of a systematic review and individual patient data meta-analysis of adults with unprovoked VTE with at least 12 months of follow-up. Cancer types were grouped according to thoracic, abdomino-pelvic, or other locations. RESULTS: A total of 2300 patients were eligible including 1218 with DVT only (53%), 719 with PE only (31%), and 363 with both PE and DVT (16%). The pooled 12-month period prevalence of cancer in DVT only, PE only, and DVT + PE was 5.6% (95% CI, 4.4 to 7.2), 4.3% (95% CI, 2.7 to 6.9), and 5.6% (95% CI, 1.7 to 15.5), respectively. Most occult cancers were located in the abdomen (68.4%). The proportion of patients with an abdomino-pelvic cancer was not different in patients with DVT + PE (81%; 95% CI, 54 to 96) than in those with DVT (68%; 95% CI, 57 to 78) or PE alone (65%; 95% CI, 48 to 79). CONCLUSION: The 12-month prevalence of occult cancer was similar in patients with DVT only, PE only, or both. Most cancers were located in the abdomen, and there was no relationship between VTE type and cancer location. Crown
BACKGROUND: Unprovoked venous thromboembolism (VTE) may be the first manifestation of an underlying cancer. We aimed to assess the period prevalence of occult cancer detection stratified by VTE location (deep vein thrombosis [DVT], pulmonary embolism [PE] or both) and the anatomical relationship between occult cancer and VTE. METHODS: Post-hoc analysis of a systematic review and individual patient data meta-analysis of adults with unprovoked VTE with at least 12 months of follow-up. Cancer types were grouped according to thoracic, abdomino-pelvic, or other locations. RESULTS: A total of 2300 patients were eligible including 1218 with DVT only (53%), 719 with PE only (31%), and 363 with both PE and DVT (16%). The pooled 12-month period prevalence of cancer in DVT only, PE only, and DVT + PE was 5.6% (95% CI, 4.4 to 7.2), 4.3% (95% CI, 2.7 to 6.9), and 5.6% (95% CI, 1.7 to 15.5), respectively. Most occult cancers were located in the abdomen (68.4%). The proportion of patients with an abdomino-pelvic cancer was not different in patients with DVT + PE (81%; 95% CI, 54 to 96) than in those with DVT (68%; 95% CI, 57 to 78) or PE alone (65%; 95% CI, 48 to 79). CONCLUSION: The 12-month prevalence of occult cancer was similar in patients with DVT only, PE only, or both. Most cancers were located in the abdomen, and there was no relationship between VTE type and cancer location. Crown