Michela Giustozzi1, Antonio Curcio2, Bob Weijs3, Thalia S Field4, Saulius Sudikas5, Anja Katholing6, Christopher Wallenhorst6, Jeffrey I Weitz7, Carlos Martinez6, Alexander T Cohen8. 1. Vascular and Emergency Medicine and Stroke Unit, University of Perugia, Perugia, Perugia, Italy. 2. Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Calabria, Italy. 3. Department of Cardiology, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht, Maastricht, Limburg, The Netherlands. 4. Division of Neurology, Vancouver Stroke Program, Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada. 5. Department of Surgery, Kantons Hospital Winterthur, Zurich, Switzerland. 6. Institute for Epidemiology, Statistics and Informatics GmbH, Frankfurt, Germany. 7. Department of Medicine, McMaster University and the Thrombosis & Atherosclerosis Research Institute, Hamilton, Canada. 8. Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, King's College London, London, United Kingdom.
Abstract
BACKGROUND: Venous thromboembolism (VTE) is a major cause of death in cancer patients. Although patients with cancer have numerous risk factors for VTE, the relative contribution of cancer treatments is unclear. OBJECTIVE: The objective of this study is to evaluate the association between cancer therapies and the risk of VTE. METHODS: From UK Clinical Practice Research Datalink, data on patients with first cancer diagnosis between 2008 and 2016 were extracted along with information on hospitalization, treatments, and cause of death. Primary outcome was active cancer-associated VTE. To establish the independent effects of risk factors, adjusted subhazard ratios (adj-SHR) were calculated using Fine and Gray regression analysis accounting for death as competing risk. RESULTS: Among 67,801 patients with a first cancer diagnosis, active cancer-associated VTE occurred in 1,473 (2.2%). During a median observation time of 1.2 years, chemotherapy, surgery, hormonal therapy, radiation therapy, and immunotherapy were given to 71.1, 37.2, 17.2, 17.5, and 1.4% of patients with VTE, respectively. The active cancers associated with the highest risk of VTE-as assessed by incidence rates-included pancreatic cancer, brain cancer, and metastatic cancer. Chemotherapy was associated with an increased risk of VTE (adj-SHR: 3.17, 95% confidence interval [CI]: 2.76-3.65) while immunotherapy with a not significant reduced risk (adj-SHR: 0.67, 95% CI: 0.30-1.52). There was no association between VTE and radiation therapy (adj-SHR: 0.91, 95% CI: 0.65-1.27) and hormonal therapies. CONCLUSION: VTE risk varies with cancer type. Chemotherapy was associated with an increased VTE risk, whereas with radiation and immunotherapy therapy, an association was not confirmed. Georg Thieme Verlag KG Stuttgart · New York.
BACKGROUND:Venous thromboembolism (VTE) is a major cause of death in cancerpatients. Although patients with cancer have numerous risk factors for VTE, the relative contribution of cancer treatments is unclear. OBJECTIVE: The objective of this study is to evaluate the association between cancer therapies and the risk of VTE. METHODS: From UK Clinical Practice Research Datalink, data on patients with first cancer diagnosis between 2008 and 2016 were extracted along with information on hospitalization, treatments, and cause of death. Primary outcome was active cancer-associated VTE. To establish the independent effects of risk factors, adjusted subhazard ratios (adj-SHR) were calculated using Fine and Gray regression analysis accounting for death as competing risk. RESULTS: Among 67,801 patients with a first cancer diagnosis, active cancer-associated VTE occurred in 1,473 (2.2%). During a median observation time of 1.2 years, chemotherapy, surgery, hormonal therapy, radiation therapy, and immunotherapy were given to 71.1, 37.2, 17.2, 17.5, and 1.4% of patients with VTE, respectively. The active cancers associated with the highest risk of VTE-as assessed by incidence rates-included pancreatic cancer, brain cancer, and metastatic cancer. Chemotherapy was associated with an increased risk of VTE (adj-SHR: 3.17, 95% confidence interval [CI]: 2.76-3.65) while immunotherapy with a not significant reduced risk (adj-SHR: 0.67, 95% CI: 0.30-1.52). There was no association between VTE and radiation therapy (adj-SHR: 0.91, 95% CI: 0.65-1.27) and hormonal therapies. CONCLUSION:VTE risk varies with cancer type. Chemotherapy was associated with an increased VTE risk, whereas with radiation and immunotherapy therapy, an association was not confirmed. Georg Thieme Verlag KG Stuttgart · New York.
Authors: Sarah Sharman Moser; Galia Spectre; Pia Raanani; Orr Friedman-Mazursky; Matanya Tirosh; Gabriel Chodick; Avi Leader Journal: Res Pract Thromb Haemost Date: 2022-05-23