Outcome of Patients with Advanced Neoplastic Disease Receiving Vena Caval Filters

Lossef, Steven V.; Barth, Klemens H.

doi:10.1016/s1051-0443(95)71113-7

Cited by 22 publications

(15 citation statements)

References 5 publications

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“…The reported 30-day mortality rate (Table 3) makes the idea that placement of an IVC filter is indicated controversial for some, because of the short survival time and the iatrogenic morbidity rate, and also because no filter is 100% efficient against a PE. The mortality rate at 1 month after IVCFP ranges from 10% to 28% in cancer patients; it was 27% in our study, which is in keeping with the results of other studies [21,23,24,25,26,27].…”

Section: Discussionsupporting

confidence: 93%

Cost–benefit assessment of inferior vena cava filter placement in advanced cancer patients

Marcy

Magné

Gallard

et al. 2002

Support Care Cancer

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We retrospectively collected data recorded between 1994 and 2000, with the aim of evaluating the cost and benefits of IVCFP (inferior vena cava filter placement) in advanced cancer patients treated in our institution alone from the radio-diagnosis department's point of view. A total of 30 procedures were performed. The benefits were represented by the efficacy and the safety of the filter. The costing procedure consisted in multiplying the value of the unit index by the number of relative complexity indices. Eighty percent (24/30) of the patients were dead at the time of the study. Twenty percent (6/30) of the patients died before even being discharged from hospital. Three of them died from renal failure, owing to complete renal vein thrombosis (n=2) or hydronephrosis (n=1), and 1 from pulmonary embolism because it was exceptionally severe; the other 2 patients were cachectic, i.e., in poor general condition. The individual cost of the procedures represented only 2% of the mean entire cost of hospitalization. Seventy-six percent, 56% and 40% of the patients, were still alive at 1 month; 3 months and 6 months, respectively, with an improved quality of survival in at least 53% of the patients. The low complication rate and the low cost relative to the mean cost of hospitalization (2%) are factors in favor of using IVCFP if it is medically indicated.

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Section: Discussionsupporting

confidence: 93%

Cost–benefit assessment of inferior vena cava filter placement in advanced cancer patients

Marcy

Magné

Gallard

et al. 2002

Support Care Cancer

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“…Though ambulatory status was a significant predictor of better survival in stage 4 cancer in one study [30], others did not find a similar association between performance status and survival at 1 year [23]. In-hospital mortality rates following filter placement ranged from 10 to 33% [19,24,28,29,31] with the mean length of hospitalization ranging from 1 to 193 days [27,31]. The cause of death leading to mortality before discharge was the underlying malignancy and multisystem organ failure in 59 patients, fatal PE in 6, sepsis in 3 and procedure related complications in 2 (fatal ventricular arrhythmia and acute IVCT).…”

Section: Survival After Ivc Filter Insertion In Cancer Patientsmentioning

confidence: 93%

“…Fourteen studies published from 1995 to 2008 looked at one or more of the outcomes of interest in 2,154 patients with all stages of cancer who had received IVC filters from 1973 to 2000 [14,16,19,[22][23][24][25][26][27][28][29][30][31][32]. All the identified studies were retrospective cohort studies or case series, except 1 prospective study that enrolled 100 patients, 26% of whom had cancer [22].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Of the 14 studies included in the review, 9 reported median survivals in patients with cancer following placement of IVC filters [14,16,19,22,23,[25][26][27]30]. The median survival post-IVC filtration ranged from 2 to 10 months for all stages of cancer, from 3 to 6.6 months for stages 3 and 4 together and from 2 to 6 months for stage 4 cancers.…”

Section: Survival After Ivc Filter Insertion In Cancer Patientsmentioning

confidence: 99%

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Inferior vena cava filters in the management of cancer-associated venous thromboembolism: a systematic review

et al. 2010

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This study systematically reviews outcomes after inferior vena cava (IVC) filtration in cancer-associated venous thromboembolism (VTE). A comprehensive review of the English language literature was performed using MEDLINE, COCHRANE library, Embase and CINAHL on outcomes (i.e., pulmonary embolism, recurrent DVT, postphlebitic syndrome and survival) following IVC filtration in cancer-associated VTE. Fourteen studies with 2,154 cancer patients receiving IVC filters post-VTE were included. All were observational studies. The mean duration of followup was 0.7-38 months and mean patient age was 56.8-68 years. Among study participants, 47-87% had stage 3 or 4 cancers. Of the 47-93% of filters inserted for contraindications to anticoagulation (AC), 10-33% were placed for relative contraindications. Recurrent PE was seen in 0-6%, fatal PE in 0-4.5%, recurrent DVT in 0-18.2%, postphlebitic syndrome (PPS) in 0-2.7%, and IVC thrombosis (ICVT) in 3% of cancer patients. Median survival post-filter insertion was 2-10 months. Evidence supporting the utility of IVC filter insertion in cancer-associated VTE is limited to observational studies only. Preliminary data demonstrate similar safety and efficacy of filters in cancer and noncancer populations. The combination of filters and anticoagulation is no more effective than either modality alone. Retrievable filters are an attractive option for prevention of VTE in the presence of temporary risk factors or temporary contraindications to anticoagulation in patients who have a reasonable life expectancy, but there is no evidence to support their preferential use in patients with advanced malignancy.

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“…In the first case, percutaneous procedures were performed to eliminate obstruction of the ureters (J-J prosthesis) [9] or the superior vena cava (SVC) [14,16,17] by tumors, for prevention of pulmonary embolism (inferior vena cava [IVC] filter) [3,13,15], and for tumor embolization [10,11,18] to achieve hemostasis.…”

Section: Methodsmentioning

confidence: 99%

Cost-benefit analysis of percutaneous interventional radiological procedures in cancer patients

Marcy¹,

Chevallier²,

Granon³

et al. 1999

Supportive Care in Cancer

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The goal of this work was to evaluate the costs and benefits of percutaneous interventional radiological procedures (PIRP) in terminal cancer patients, from the perspective of the Radiodiagnostics Department. The subjects were 225 patients who underwent different kinds of treatments, such as placement of endovenous or urinary stents, percutaneous gastrostomy, alcoholization of metastatic disease, celiac plexus block, tumor embolization, and inferior vena caval filter. We retrospectively analyzed the consequences in terms of survival, quality of life and cost ratios and found that this study fully justifies the use of interventional radiology in palliative oncology: 60% and 40% of the patients, respectively, were still alive at 1 month and 3 months; the additional cost of PIRP procedures is low (< 12%) compared with the total cost of hospitalization.

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Outcome of Patients with Advanced Neoplastic Disease Receiving Vena Caval Filters

Cited by 22 publications

References 5 publications

Cost–benefit assessment of inferior vena cava filter placement in advanced cancer patients

Cost–benefit assessment of inferior vena cava filter placement in advanced cancer patients

Inferior vena cava filters in the management of cancer-associated venous thromboembolism: a systematic review

Cost-benefit analysis of percutaneous interventional radiological procedures in cancer patients

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