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The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site

2016; Elsevier BV; Volume: 130; Issue: 3 Linguagem: Inglês

10.1016/j.amjmed.2016.10.017

1555-7162

Isabelle Mahé, Jean Chidiac, Laurent Bertoletti, Carme Font, Javier Trujillo‐Santos, M.L. Peris, Cristina Pérez Ductor, Santiago Nieto, Elvira Grandone, Manuel Monréal, M.A. Aibar, J.I. Arcelus, Aitor Ballaz, Raquel Barba, M. Barrón, B. Barrón‐Andrés, José Bascuñana, Á. Blanco-Molina, Tulio Bueso, I. Casado, Alex Culla, Javier de Miguel‐Díez, J. del Toro, J.A. Díaz‐Peromingo, C. Falgá, Carmen Fernández‐Capitán, Carme Font, Llorenç Font, P. Gallego, F. García‐Bragado, P. García-Brotons, Vicente Gómez, J. González, E Grau, A. Grimón, L. Guirado, Juan Mata, Giselle Riquelme Hernández, Luis Blasco, V. Isern, Luis Jara‐Palomares, M.J. Jaras, David Jiménez, B. Lacruz, Ramón Lecumberri, J.L. Lobo, Luciano López-Jiménez, Raquel López-Reyes, J.B. López‐Sáez, M.A. Lorente, A. Lorenzo, Olga Madridano, P.J. Marchena, J.M. Martín‐Antorán, F. Martín‐Martos, Manuel Monréal, M.V. Morales, D. Nauffal, J.A. Nieto, Santiago Nieto, M.J. Núñez, S. Otálora, Remedios Otero, B. Pagán, José María Pedrajas, Cecilia E González Pérez, Gustavo Pérez, M.L. Peris, José Antonio Porras, L. Ramírez, Óscar Reig, Antoni Riéra, A. Rivas, M.A. Rodríguez‐Dávila, V. Rosa, Pedro Ruiz‐Artacho, N. Ruiz‐Giménez, Carlos Ruíz-Martinez, A. Sampériz, Carlos Sala, O. Sanz, S. Soler, B. Sopeña, Ignacio Donate Suárez, J.M. Suriñach, G Tiberio, C. Tolosa, Javier Trujillo‐Santos, Fernando Uresandi, R. Valle, J. Vela, J Villalta, Pablo Malfante, Peter Verhamme, Philip Wells, Jana Hirmerová, Radován Malý, T. Tomko, E. Salgado, Laurent Bertoletti, A. Bura-Rivière, Dominique Farge, A. Hij, I. Mahé, A. Merah, Marios Papadakis, Andrei Braester, Benjamin Brenner, Inna Tzoran, A. Apollonio, Giovanni Barillari, Giampiero Candeloro, Maurizio Ciammaichella, P. Di Micco, Paola Ferrazzi, Elvira Grandone, Gianfranco Lessiani, Corrado Lodigiani, Daniela Mastroiacovo, F. Pace, Massimiliano Pinelli, Paolo Prandoni, L. Rota, Eros Tiraferri, Antonella Tufano, Adriana Visonà, A. Belovs, Andris Skride, Margarida Cardoso-Moreira, José Luís Pais Ribeiro, Mariana S. Sousa, Marijan Bosevski, Marija Zdraveska, Adriano Alatri, Henri Bounameaux, Luca Calanca, Lucia Mazzolai, Juan Carlos Serrano, Hervé Decousus, Abílio Reis,

Central Venous Catheters and Hemodialysis

We hypothesized that the clinical course of venous thromboembolism in patients with active cancer may differ according to the specificities of primary tumor site.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).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).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.