Venous thromboembolism and cancer

Hb, Rahr; Jv, Sørensen

doi:10.1097/00001721-199203040-00012

Cited by 50 publications

(25 citation statements)

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“…The risk of venous thrombosis has previously been shown to be higher in cancer patients who receive chemotherapy [8,12,13] compared with those without chemotherapy. In addition, an increase in risk has been described before for radiotherapy [14] and surgery [15], but in our study there was no increase in risk during or after being treated with radiotherapy.…”

Section: Time Since Metastases (Years)contrasting

confidence: 50%

High risk of venous thrombosis in patients with pancreatic cancer: A cohort study of 202 patients

Blom

Osanto

Rosendaal

2006

European Journal of Cancer

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Epidemiology A B S T R A C TTo estimate the risk of venous thrombosis associated with pancreatic malignancies we followed a cohort of patients with pancreatic cancer (n = 202). We calculated incidence rates of venous thrombosis and compared this with population rates using a Standardised Morbidity Ratio (SMR). The effects of location, histology and treatment were assessed by Coxmodelling. The incidence of venous thrombosis was 108.3/1000 patient-years (95% confidence interval (CI) 64.4-163.8), 58.6-fold increased (SMR 58.6, 95% CI 36.9-92.9).Patients with a tumour of the corpus/cauda had a 2-fold increased risk compared with those with a tumour of the caput. Patients treated with chemotherapy had a 4.8-fold increased risk (HR adj 4.8, 95% CI 1.1-20.8), whereas radiotherapy did not increase the risk.In a postoperative period of 30 d, patients had a 4.5-fold increased risk of venous thrombosis (HR adj 4.5, 95% CI 0.5-40.9). The risk was 1.9-fold increased in the presence of distant metastases (HR adj 1.9, 95% CI 0.7-5.1). Anti-thrombotic prophylaxis seems warranted in the first month after surgery, during and after treatment with chemotherapy, and when distant metastases have been diagnosed.

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Section: Time Since Metastases (Years)contrasting

confidence: 50%

High risk of venous thrombosis in patients with pancreatic cancer: A cohort study of 202 patients

Blom

Osanto

Rosendaal

2006

European Journal of Cancer

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“…Advanced cancers are associated with a high incidence of VTE, especially cancers of the breast, lung, brain, pelvis, rectum, pancreas, and gastrointestinal tract. 33,34 Administration of chemotherapy increases risk. For example, patients with newly diagnosed multiple myeloma receiving thalidomide with multiagent chemotherapy have an increased risk of thrombotic events.…”

Section: Malignancymentioning

confidence: 99%

Risk Factors for Venous Thromboembolism

2003

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Abstract-Until the 1990s, venous thromboembolism (VTE) was viewed primarily as a complication of hospitalization for major surgery (or associated with the late stage of terminal illness). However, recent trials in patients hospitalized with a wide variety of acute medical illnesses have demonstrated a risk of VTE in medical patients comparable with that seen after major general surgery. In addition, epidemiologic studies have shown that between one quarter and one half of all clinically recognized symptomatic VTEs occur in individuals who are neither hospitalized nor recovering from a major illness. This expanding understanding of the population at risk challenges physicians to carefully examine risk factors for VTE to identify high-risk patients who could benefit from prophylaxis. Factors sufficient by themselves to prompt physicians to consider VTE prophylaxis include major surgery, multiple trauma, hip fracture, or lower extremity paralysis because of spinal cord injury. Additional risk factors, such as previous VTE, increasing age, cardiac or respiratory failure, prolonged immobility, presence of central venous lines, estrogens, and a wide variety of inherited and acquired hematological conditions contribute to an increased risk for VTE. These predisposing factors are seldom sufficient by themselves to justify the use of prophylaxis. Nevertheless, individual risk factors, or combinations thereof, can have important implications for the type and duration of appropriate prophylaxis and should be carefully reviewed to assess the overall risk of VTE in each patient. Key Words: thrombus Ⅲ risk factors Ⅲ prevention Ⅲ embolism V TE consists of 2 related conditions: deep vein thrombosis (DVT) and pulmonary embolism (PE). This review summarizes the strength of the evidence regarding specific risk factors for VTE and provides a guide for identifying patients who could benefit from VTE prophylaxis. This article also identifies population groups whose apparent risk for VTE is too low to justify preventive treatment.In 1884, Rudolph Virchow first proposed that thrombosis was the result of at least 1 of 3 underlying etiologic factors: vascular endothelial damage, stasis of blood flow, and hypercoagulability of blood. In the last century, recognition that all DVT risk factors reflect these underlying pathophysiologic processes and that VTE does not usually develop in their absence has increased. In a review of 1231 consecutive patients treated for VTE, 96% had Ն1 recognized risk factor (Table 1). 1 Furthermore, there is convincing evidence that risk increases in proportion to the number of predisposing factors (Figure 1). 2,3 The majority of clinically recognized instances of VTE are suspected because of typical signs and symptoms in individuals who present to an outpatient clinic or hospital emergency department; 1 only one quarter to one half of VTE are diagnosed in patients who are or were recently hospitalized. 1,4,5 Risk factors convincingly demonstrated for VTE include increasing age, prolonged immobility, malignancy...

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“…Many factors are thought to contribute to the risk of VTE, including the primary tumor site, age, immobility, and type of therapeutic intervention [6,7]. For example, operations for cancer are associated with a higher risk of VTE and fatal PE than noncancer surgery [8]. Chemotherapy, particularly when combined with hormone therapy, also increases the risk of VTE [9].…”

Section: Introductionmentioning

confidence: 99%

Venous Thrombosis in Cancer Patients: Insights from the FRONTLINE Survey

et al. 2003

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Background. Venous thromboembolism (VTE) is a common complication in cancer patients and a significant cause of morbidity and mortality. However, little information is available on oncologists' perceptions of the risk of VTE and its management. The Fundamental Research in Oncology and Thrombosis (FRONTLINE) study is the first comprehensive global survey of thrombosis and cancer. The study was designed to collect data on the perceived risk and patterns of practice with regard to VTE in cancer patients undergoing surgical and medical management of their malignancy and to provide information on international and regional practice patterns, allowing for the design of research studies to answer the concerns of practicing clinicians.Methods. Literature reviews were performed to provide a current evidence base against which to compare the findings, and a survey was developed under the guidance of an advisory board. A paper-based replypaid questionnaire was distributed globally between July and November 2001 to clinicians involved in cancer care and was made available on a dedicated website.Findings. A total of 3,891 completed responses were available for analysis. Brain and pancreatic tumors were considered to carry a high risk for VTE, and 80% of respondents considered the use of central venous lines to be associated with a high risk of VTE. Marked differences were seen in the use of thromboprophylaxis for

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Venous thromboembolism and cancer

Cited by 50 publications

References 0 publications

High risk of venous thrombosis in patients with pancreatic cancer: A cohort study of 202 patients

High risk of venous thrombosis in patients with pancreatic cancer: A cohort study of 202 patients

Risk Factors for Venous Thromboembolism

Venous Thrombosis in Cancer Patients: Insights from the FRONTLINE Survey

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