TY - JOUR
T1 - The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site
AU - Mahé, Isabelle
AU - Chidiac, Jean
AU - Bertoletti, Laurent
AU - Font, Carme
AU - Trujillo-Santos, Javier
AU - Peris, Marisa
AU - Pérez Ductor, Cristina
AU - Nieto, Santiago
AU - Grandone, Elvira
AU - Monreal, Manuel
AU - The RIETE Investigators
A2 - Aibar, M. A.
A2 - Arcelus, J. I.
A2 - Ballaz, A.
A2 - Barba, R.
A2 - Barrón, M.
A2 - Barrón-Andrés, B.
A2 - Bascuñana, J.
A2 - Blanco-Molina, A.
A2 - Bueso, T.
A2 - Casado, I.
A2 - Culla, A.
A2 - de Miguel, J.
A2 - del Toro, J.
A2 - Díaz-Peromingo, J. A.
A2 - Falgá, C.
A2 - Fernández-Capitán, C.
A2 - Font, L.
A2 - Gallego, P.
A2 - García-Bragado, F.
A2 - García-Brotons, P.
A2 - Gómez, V.
A2 - González, J.
A2 - Grau, E.
A2 - Hernández, G.
A2 - Isern, V.
A2 - Jara-Palomares, L.
A2 - Jaras, M. J.
A2 - Jiménez, D.
A2 - López-Reyes, R.
A2 - López-Sáez, J. B.
A2 - Lorente, M. A.
A2 - Skride, A.
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2017/3
Y1 - 2017/3
N2 - Background. We hypothesized that the clinical course of venous thromboembolism in patients with active cancer may differ according to the specificities of primary tumor site. Aim and Methods. We used data from RIETE (international registry of patients with venous thromboembolism) to compare the clinical venous thromboembolism-related outcomes during the course of anticoagulation in patients with one of the 4 more frequent cancers (breast, prostate, colorectal, or lung cancer). Results. As of September 2014, 3947 cancer patients were recruited, of whom 938 had breast, 629 prostate, 1189 colorectal, and 1191 lung cancer. Overall, 55% had metastatic disease (42%, 36%, 53%, and 72%, respectively). During the course of anticoagulant therapy (mean duration, 139 days), the rate of thromboembolic recurrences was similar to the rate of major bleeding in patients with breast (5.6 [95% confidence interval (CI), 3.8-8.1] vs 4.1 [95% CI, 2.7-5.9] events per 100 patient-years) or colorectal cancer (10 [95% CI, 7.6-13] vs 12 [95% CI, 9.4-15] per 100 patient-years). In contrast, in patients with prostate cancer, the rate of venous thromboembolic recurrences was half the rate of major bleeding (6.9 [95% CI, 4.4-10] vs 13 [95% CI, 9.2-17] events per 100 patient-years), whereas in those with lung cancer, the rate of thromboembolic recurrences was twofold higher than the rate of major bleeding (27 [95% CI, 22-23] vs 11 [95% CI, 8.6-15] per 100 patient-years). Conclusions. Significant differences in the clinical profile of venous thromboembolic-related outcomes were observed according to the site of cancer. These findings suggest the development of cancer-specific anticoagulant strategies as an area for further research.
AB - Background. We hypothesized that the clinical course of venous thromboembolism in patients with active cancer may differ according to the specificities of primary tumor site. Aim and Methods. We used data from RIETE (international registry of patients with venous thromboembolism) to compare the clinical venous thromboembolism-related outcomes during the course of anticoagulation in patients with one of the 4 more frequent cancers (breast, prostate, colorectal, or lung cancer). Results. As of September 2014, 3947 cancer patients were recruited, of whom 938 had breast, 629 prostate, 1189 colorectal, and 1191 lung cancer. Overall, 55% had metastatic disease (42%, 36%, 53%, and 72%, respectively). During the course of anticoagulant therapy (mean duration, 139 days), the rate of thromboembolic recurrences was similar to the rate of major bleeding in patients with breast (5.6 [95% confidence interval (CI), 3.8-8.1] vs 4.1 [95% CI, 2.7-5.9] events per 100 patient-years) or colorectal cancer (10 [95% CI, 7.6-13] vs 12 [95% CI, 9.4-15] per 100 patient-years). In contrast, in patients with prostate cancer, the rate of venous thromboembolic recurrences was half the rate of major bleeding (6.9 [95% CI, 4.4-10] vs 13 [95% CI, 9.2-17] events per 100 patient-years), whereas in those with lung cancer, the rate of thromboembolic recurrences was twofold higher than the rate of major bleeding (27 [95% CI, 22-23] vs 11 [95% CI, 8.6-15] per 100 patient-years). Conclusions. Significant differences in the clinical profile of venous thromboembolic-related outcomes were observed according to the site of cancer. These findings suggest the development of cancer-specific anticoagulant strategies as an area for further research.
KW - Anticoagulant therapy
KW - Bleeding
KW - Cancer
KW - Mortality
KW - Recurrences
KW - Venous thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=85008471358&partnerID=8YFLogxK
UR - https://www.riete.org/info/centros_participantes/index.php
U2 - 10.1016/j.amjmed.2016.10.017
DO - 10.1016/j.amjmed.2016.10.017
M3 - Article
C2 - 27884650
AN - SCOPUS:85008471358
SN - 0002-9343
VL - 130
SP - 337
EP - 347
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 3
ER -