Relevance of recurrent venous thromboembolism according to location of metastasis in patients with cancer-associated thrombosis. A cohort study

IF 3.7 3区医学 Q1 HEMATOLOGY

Thrombosis research Pub Date : 2024-11-23 DOI:10.1016/j.thromres.2024.109228

Victor Garcia-Garcia , Maria Barca-Hernando , Sergio Lopez-Ruz , Carmen Rosa-Linares , Teresa Elias-Hernandez , Remedios Otero-Candelera , David Gutierrez-Campos , Henry Andrade-Ruiz , Marc Carrier , Luis Jara-Palomares

{"title":"Relevance of recurrent venous thromboembolism according to location of metastasis in patients with cancer-associated thrombosis. A cohort study","authors":"Victor Garcia-Garcia , Maria Barca-Hernando , Sergio Lopez-Ruz , Carmen Rosa-Linares , Teresa Elias-Hernandez , Remedios Otero-Candelera , David Gutierrez-Campos , Henry Andrade-Ruiz , Marc Carrier , Luis Jara-Palomares","doi":"10.1016/j.thromres.2024.109228","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Risk of VTE recurrence (VTEr) in patients with cancer-associated thrombosis (CAT) is high. Cancer-related risk factors for VTEr have been studied, but information about the importance of location of metastasis is scarce.</div></div><div><h3>Objectives</h3><div>1) Evaluate rate of VTEr in CAT patients according to location of metastasis, and 2) Identify variables associated to VTEr during long-term follow-up.</div></div><div><h3>Methods</h3><div>A retrospective, single-center, non-interventional study of consecutives patients with CAT conducted between 2007 and 2022. Haematological neoplasms were excluded.</div></div><div><h3>Results</h3><div>Among 1248 patients with CAT (age 64.1 ± 12.8 years; 48.2 % female) followed-up for 13.19 months (p25–75, 5.6–26.9) there were 141 VTEr. The rate of VTE recurrence in patients without and with metastasis were 4.72 per 100 patient-years (95%CI: 3.66–6) and 10.05 per 100 patient-years (95 % CI: 7.89–12.61), respectively. The metastases locations associated with VTEr, compared to those without metastasis, were lung (rate ratio [RR]: 2.21; 95 % CI: 1.42–3.43), liver (RR: 2.02; 95%CI: 1.26–3.24), pancreas (RR: 6.21; 95 % CI: 1.52–25.35), pleura (RR: 2.93; 95%CI: 1.58–5.41), bone (RR: 2.16; 95 % CI: 1.29–3.64) and adrenal (RR: 6.18; 95%CI: 2.97–12.86). Multivariate analysis of variables associated with VTEr beyond 12 months were male sex (hazard ratio [HR] 1.54, 95%CI: 1.08–2.19), ECOG performance status >1 (HR 1.74, 95%CI: 1.03–2.94), metastasis in 1–2 locations (HR 2.38, 95%CI: 1.68–3.37) and metastasis in >2 locations (HR 3.88, 95%CI: 1.68–8.98).</div></div><div><h3>Conclusions</h3><div>The rate of VTEr differs according to the location of metastasis. We identified variables related to VTEr during long-term follow-up which may help clinicians decide whether to continue anticoagulation.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"245 ","pages":"Article 109228"},"PeriodicalIF":3.7000,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Thrombosis research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0049384824003608","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Risk of VTE recurrence (VTEr) in patients with cancer-associated thrombosis (CAT) is high. Cancer-related risk factors for VTEr have been studied, but information about the importance of location of metastasis is scarce.

Objectives

1) Evaluate rate of VTEr in CAT patients according to location of metastasis, and 2) Identify variables associated to VTEr during long-term follow-up.

Methods

A retrospective, single-center, non-interventional study of consecutives patients with CAT conducted between 2007 and 2022. Haematological neoplasms were excluded.

Results

Among 1248 patients with CAT (age 64.1 ± 12.8 years; 48.2 % female) followed-up for 13.19 months (p25–75, 5.6–26.9) there were 141 VTEr. The rate of VTE recurrence in patients without and with metastasis were 4.72 per 100 patient-years (95%CI: 3.66–6) and 10.05 per 100 patient-years (95 % CI: 7.89–12.61), respectively. The metastases locations associated with VTEr, compared to those without metastasis, were lung (rate ratio [RR]: 2.21; 95 % CI: 1.42–3.43), liver (RR: 2.02; 95%CI: 1.26–3.24), pancreas (RR: 6.21; 95 % CI: 1.52–25.35), pleura (RR: 2.93; 95%CI: 1.58–5.41), bone (RR: 2.16; 95 % CI: 1.29–3.64) and adrenal (RR: 6.18; 95%CI: 2.97–12.86). Multivariate analysis of variables associated with VTEr beyond 12 months were male sex (hazard ratio [HR] 1.54, 95%CI: 1.08–2.19), ECOG performance status >1 (HR 1.74, 95%CI: 1.03–2.94), metastasis in 1–2 locations (HR 2.38, 95%CI: 1.68–3.37) and metastasis in >2 locations (HR 3.88, 95%CI: 1.68–8.98).

Conclusions

The rate of VTEr differs according to the location of metastasis. We identified variables related to VTEr during long-term follow-up which may help clinicians decide whether to continue anticoagulation.

查看原文本刊更多论文

根据癌症相关血栓患者转移部位的静脉血栓栓塞复发的相关性。队列研究

癌症相关血栓（CAT）患者静脉血栓栓塞（VTE）复发的风险很高。VTEr的癌症相关危险因素已有研究，但转移部位的重要性尚缺乏相关信息。目的1)根据转移部位评估CAT患者VTEr的发生率，2)在长期随访中确定与VTEr相关的变量。方法回顾性、单中心、非介入性研究，对2007年至2022年间连续的CAT患者进行研究。排除血液学肿瘤。结果1248例CAT患者(年龄64.1±12.8岁；随访13.19个月（p25 ~ 75,5.6 ~ 26.9）， VTEr 141例。无转移和有转移的VTE复发率分别为4.72 / 100患者-年（95%CI: 3.66-6）和10.05 / 100患者-年（95%CI: 7.89-12.61）。与无转移者相比，与VTEr相关的转移部位为肺(比率比[RR]: 2.21；95% CI: 1.42-3.43)，肝脏(RR: 2.02；95%CI: 1.26-3.24)，胰腺(RR: 6.21；95% CI: 1.52-25.35)，胸膜(RR: 2.93；95%CI: 1.58-5.41)，骨(RR: 2.16；95% CI: 1.29-3.64)和肾上腺素(RR: 6.18；95%置信区间:2.97—-12.86)。12个月后与VTEr相关的多因素分析为男性（危险比[HR] 1.54, 95%CI: 1.08-2.19）、ECOG运动状态>；1（危险比[HR] 1.74, 95%CI: 1.03-2.94）、1 - 2个部位转移（危险比[HR] 2.38, 95%CI: 1.68-3.37）和>；2个部位转移（危险比[HR] 3.88, 95%CI: 1.68-8.98）。结论VTEr的发生率随转移部位的不同而不同。我们在长期随访中确定了与VTEr相关的变量，这可能有助于临床医生决定是否继续抗凝治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Thrombosis research 医学-外周血管病

CiteScore

14.60

自引率

4.00%

发文量

364

审稿时长

31 days

期刊介绍： Thrombosis Research is an international journal dedicated to the swift dissemination of new information on thrombosis, hemostasis, and vascular biology, aimed at advancing both science and clinical care. The journal publishes peer-reviewed original research, reviews, editorials, opinions, and critiques, covering both basic and clinical studies. Priority is given to research that promises novel approaches in the diagnosis, therapy, prognosis, and prevention of thrombotic and hemorrhagic diseases.