Robert A Schmidt1, Alaa Al Zaki1, Nikolas Desilet1, Elena Szefer2, Namali Ratnaweera3, Erica Peterson1, Agnes Y Y Lee4. 1. Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada. 2. Emmes Canada, 200-4664 Lougheed Highway, Burnaby, BC V5C 3Y2, Canada. 3. University of Victoria, Faculty of Science, 3800 Finnerty Road, Victoria, BC V8P 5C2, Canada. 4. Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada; BC Cancer, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, Canada. Electronic address: alee14@bccancer.bc.ca.
Abstract
INTRODUCTION: Little is known about the clinical course and treatment decisions in patients with cancer-associated venous thromboembolism (VTE) beyond the initial treatment period of 3 to 6 months. This information is important for clinicians and patients to inform their decisions regarding duration of anticoagulation. MATERIALS AND METHODS: We reviewed health records from consecutive patients referred to our institution for cancer-associated VTE management between 2013 and 2015 to describe their clinical course and outcomes from 6 to 24 months following their index VTE. Details on patient and cancer characteristics, objectively documented recurrent venous thromboembolism (rVTE), clinically relevant bleeding (CRB) and overall mortality were captured. RESULTS: 524 patients met eligibility criteria and 322 were alive at 6 months after the index VTE. At 6 months, anticoagulation was continued in 222 patients (68.9%). During follow-up, there were 33 rVTE events in 30 patients (1-year cumulative incidence of 8.2%; 95% CI: 5.5%-11.6%), and 16 CRB events in 15 patients (1-year cumulative incidence of 4.1%; 95% CI: 2.3%-6.7%); 20 (60.6%) rVTE events and 13 (81.3%) CRB events occurred while on anticoagulation. One-year survival beyond 6 months was 73.7% (95% CI: 68.5%-78.2%). A higher proportion of patients with advanced cancer and receiving cancer treatment was found among those who continued anticoagulation beyond 6 months compared to those who stopped anticoagulation. CONCLUSIONS: Patients with cancer-associated VTE who are alive at 6 months after VTE diagnosis remain at high risk of rVTE, CRB and death.
INTRODUCTION: Little is known about the clinical course and treatment decisions in patients with cancer-associated venous thromboembolism (VTE) beyond the initial treatment period of 3 to 6 months. This information is important for clinicians and patients to inform their decisions regarding duration of anticoagulation. MATERIALS AND METHODS: We reviewed health records from consecutive patients referred to our institution for cancer-associated VTE management between 2013 and 2015 to describe their clinical course and outcomes from 6 to 24 months following their index VTE. Details on patient and cancer characteristics, objectively documented recurrent venous thromboembolism (rVTE), clinically relevant bleeding (CRB) and overall mortality were captured. RESULTS: 524 patients met eligibility criteria and 322 were alive at 6 months after the index VTE. At 6 months, anticoagulation was continued in 222 patients (68.9%). During follow-up, there were 33 rVTE events in 30 patients (1-year cumulative incidence of 8.2%; 95% CI: 5.5%-11.6%), and 16 CRB events in 15 patients (1-year cumulative incidence of 4.1%; 95% CI: 2.3%-6.7%); 20 (60.6%) rVTE events and 13 (81.3%) CRB events occurred while on anticoagulation. One-year survival beyond 6 months was 73.7% (95% CI: 68.5%-78.2%). A higher proportion of patients with advanced cancer and receiving cancer treatment was found among those who continued anticoagulation beyond 6 months compared to those who stopped anticoagulation. CONCLUSIONS:Patients with cancer-associated VTE who are alive at 6 months after VTE diagnosis remain at high risk of rVTE, CRB and death.
Authors: Isabelle Mahé; Giancarlo Agnelli; Cihan Ay; Aristotelis Bamias; Cecilia Becattini; Marc Carrier; Céline Chapelle; Alexander T Cohen; Philippe Girard; Menno V Huisman; Frederikus A Klok; Juan J López-Núñez; Anthony Maraveyas; Didier Mayeur; Olivier Mir; Manuel Monreal; Marc Righini; Charles M Samama; Kostas Syrigos; Sebastian Szmit; Adam Torbicki; Peter Verhamme; Eric Vicaut; Tzu-Fei Wang; Guy Meyer; Silvy Laporte Journal: Thromb Haemost Date: 2021-11-05 Impact factor: 6.681
Authors: Marc Carrier; Normand Blais; Mark Crowther; Petr Kavan; Grégoire Le Gal; Otto Moodley; Sudeep Shivakumar; Deepa Suryanarayan; Vicky Tagalakis; Cynthia Wu; Agnes Y Y Lee Journal: Curr Oncol Date: 2021-12-18 Impact factor: 3.677