Patterns of venous thromboembolism risk in patients with localized colorectal cancer undergoing adjuvant chemotherapy or active surveillance: an observational cohort study

• Published in: BMC cancer 2017-06, Vol.17 (1), p.415-415, Article 415
• Main Authors: Riedl, Jakob Michael, Posch, Florian, Bezan, Angelika, Szkandera, Joanna, Smolle, Maria Anna, Winder, Thomas, Rossmann, Christopher H, Schaberl-Moser, Renate, Pichler, Martin, Stotz, Michael, Stöger, Herbert, Gerger, Armin
• Format: Article
• Language: English
• Subjects: Adjuvant chemotherapy; Adult; Aged; Aged, 80 and over; Anticoagulants; Cancer therapies; Care and treatment; Chemotherapy; Chemotherapy, Adjuvant; Cohort analysis; Cohort Studies; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - complications; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Complications and side effects; Female; Follow-Up Studies; Health aspects; Health risk assessment; Humans; Illnesses; Male; Metastases; Metastasis; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Observational studies; Prognosis; Recurrence; Recurrence (Disease); Risk; Risk factors; Stroke; Surgery; Surveillance; Thromboembolism; Thrombosis; Venous thromboembolism; Venous Thromboembolism - epidemiology; Venous Thromboembolism - etiology; Venous Thromboembolism - mortality; Venous thrombosis; Young Adult
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-017-3392-4

Venous thromoboembolism (VTE) is a frequent and burdensome complication of metastatic colorectal cancer (CRC). However, the epidemiology of VTE in patients with localized CRC after surgery in curative intent is incompletely understood. In this single-center observational cohort study, we investigate patterns of VTE risk in localized CRC, and define its relationship with baseline risk factors, adjuvant chemotherapy and CRC recurrence. Five-hundred-sixteen patients with stage II/III CRC were included retrospectively at the time of surgery, and followed until the occurrence of VTE, CRC recurrence, or death (median age = 65.1 years, stage II and III: n = 151 (29.5%), n = 361 (70.5%); adjCTX: n = 339 (65.7%)). During a median follow-up of 2.7 years, 15 VTEs (2.7%) and 116 recurrences (22.5%) occurred, and 46 patients (8.9%) died. Six-month, 1-year, and 5-year VTE risks were 1.6%, 2.0% and 3.2%, respectively. In competing risk time-to-VTE regression, adjCTX was not associated with an increased risk of VTE (Subdistribution hazard ratio = 0.98, 95% CI:0.33-2.88, p = 0.97). The occurrence of disease recurrence strongly increased the risk of VTE (Multi-state model: Transition hazard ratio (THR) = 13.03, 95% CI:4.39-38.74, p