Venous Thromboembolism in Solid Cancer Patients
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Abstract
Background: Venous thromboembolism (VTE) is a frequent and significant complication of cancer. Many previous studies showed that malignancy was the most common acquired cause of VTE which potential caused many effects on cancer patients themselves, treatments and prognosis.
Objectives: To identify the incidence of VTE, risk factors and review the characteristics, clinical course including VTE treatment of patients with solid cancer who had VTE.
Methods: Non-gynecological solid cancer patients with VTE, treated at Ramathibodi hospital during January 2003 to December 2007, were enrolled in this study. Patient characteristics were obtained from their medical records with emphasis on primary site of cancer, staging, demographics, type of cancer treatment and circumstantial vascular risk factors.
Results: There are 178 cancer patients included in this study. The mean age of the patients is 58.77 years. It is equally by sex. Among the patients, lung, colorectal, hepatocellular carcinoma (HCC), breast cancer and cholangiocarcinoma are the top five most common cancers respectively. Our study shows that cancer patients with VTE tend to have advanced stage, higher recurrence and poorer response to treatment. Adenocarcinomas are the most common type of cancer in our study. Approximately 50% of our patients developed VTE at the same time with cancer diagnosis. The latter had developed this condition for the mean of 13.3 months later from that time. PORT implantation and some primary tumors are related with sites of VTE. Median time from VTE presentation until death is 22.3 months. Female has significantly better prognosis than male patients (p = 0.0123). Breast and colorectal cancers also have the same than others too (p < 0.001). One third of the patients treated with anticoagulant had major bleeding complication and 60% of them occurred within 1 month after warfarin usage.
Conclusion: Cancer patients with VTE have poor prognosis and tend to have more advanced stage and poorer response to therapy. Moreover, they might increase bleeding complication from anticoagulation therapy. However, our populations are too small to determine other risk factors which previously reported. Large number of patient needs to be more study in this condition.
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References
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