Influence of primary cancer site on clinical outcomes of anticoagulation for associated venous thromboembolism

The outcome of anticoagulation for cancer-associated venous thromboembolism (Ca-VTE) differs according to cancer location, but data are limited and inconsistent. Patients with acute venous thromboembolism (VTE) enrolled between 03/01/2013 and 04/30/2021 were followed prospectively to assess VTE recu...

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Published in:Thrombosis research 2023-01, Vol.221, p.37-44
Main Authors: Wysokinski, Waldemar E., Houghton, Damon E., Vlazny, Danielle T., Ashrani, Aneel A., Froehling, David A., Kamath, Patrick S., Meverden, Ryan A., Hodge, David O., Peterson, Lisa G., Lang, Teresa R., McBane, Robert D., Casanegra, Ana I.
Format: Article
Language:English
Subjects:
Anticoagulants
Anticoagulants - pharmacology
Anticoagulants - therapeutic use
Blood Coagulation
Hemorrhage
Humans
Male
Neoplasm Recurrence, Local
Neoplasms
Neoplasms - complications
Neoplasms - drug therapy
Recurrence
Treatment failure
Venous Thromboembolism - drug therapy
Venous Thromboembolism - etiology
Venous thrombosis
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Summary:The outcome of anticoagulation for cancer-associated venous thromboembolism (Ca-VTE) differs according to cancer location, but data are limited and inconsistent. Patients with acute venous thromboembolism (VTE) enrolled between 03/01/2013 and 04/30/2021 were followed prospectively to assess VTE recurrence, major bleeding (MB), clinically relevant non-major bleeding (CRNMB), and death. There were 1702 (45.3 %) patients with Ca-VTE including: gastrointestinal (n = 340), pancreatic (n = 223), hematologic (n = 188), genitourinary (n = 163), lung (n = 139), ovarian (n = 109), breast (n = 97), renal (n = 75), prostate (n = 73), hepatobiliary (n = 70), brain (n = 57), and other cancers (n = 168); 2057 VTE patients had no cancer (NoCa-VTE). Hepatobiliary cancer had the highest VTE recurrence (all rates 100 person-years) of all cancers and higher compared to NoCa-VTE (13.69, p = 0.01), while the MB rate, although numerically higher (15.91), was not different (p = 0.09). Another 3 cancers had higher VTE recurrence but similar MB rates compared to NoCa-VTE: genitourinary [(9.59, p = 0.01) and (7.03, p = 1.0)], pancreatic [(9.74, p 
ISSN:0049-3848
1879-2472
DOI:10.1016/j.thromres.2022.11.005