静脉血栓栓塞在胃癌中的发病率和预后作用：一项芬兰全国性登记研究

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2025-05-08 DOI:10.1016/j.ejso.2025.110139

Panu Aaltonen , Harri Mustonen , Pauli Puolakkainen , Caj Haglund , Katriina Peltola , Hanna Seppänen

{"title":"静脉血栓栓塞在胃癌中的发病率和预后作用：一项芬兰全国性登记研究","authors":"Panu Aaltonen , Harri Mustonen , Pauli Puolakkainen , Caj Haglund , Katriina Peltola , Hanna Seppänen","doi":"10.1016/j.ejso.2025.110139","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Gastric cancer (GC) is associated with a high risk of venous thromboembolism (VTE). We investigated the incidence of VTE before and after a GC diagnosis and its association with overall survival (OS).</div></div><div><h3>Methods</h3><div>We identified GC patients diagnosed in 2011–2016 from the Finnish Cancer Registry, and collected data on healthcare visits, death, and follow-up through the end of 2020. We compared patients based on their cancer stage and the type of treatment they received.</div></div><div><h3>Results</h3><div>We identified 3023 GC patients, amongst whom 995 (32.9 %) underwent gastric surgery, 134 (4.4 %) explorative surgery, and 1894 (62.7 %) no surgery for GC. The cumulative incidence of VTE at 12 and 24 months following GC diagnosis was 5.1 % [95 % confidence interval (CI) 4.31–5.89] and 5.8 % (95 % CI 4.97–6.63), respectively. VTE within one year before GC diagnosis was significantly more frequent amongst no surgery (1.9 %) patients than amongst the gastric (0.8 %) or exploratory surgery only (0.7 %) subgroups (<em>p</em> = 0.018). Median OS amongst patients who had a VTE within one year before a GC diagnosis was 4 months compared to 10 months amongst those who did not (<em>p</em> = 0.001). VTE similarly associated with a worse prognosis, whether occurring within one year before [hazard ratio (HR) 1.69] or after (HR 1.78) a GC diagnosis.</div></div><div><h3>Conclusions</h3><div>VTE associated with a worse survival, whether occurring before or after a GC diagnosis. Pre-diagnosis VTE associated with a lower likelihood of curative-intent surgery presumably due to more advanced GC or VTE-related treatment interference.</div></div>","PeriodicalId":11522,"journal":{"name":"Ejso","volume":"51 7","pages":"Article 110139"},"PeriodicalIF":3.5000,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Incidence and prognostic role of venous thromboembolism in gastric cancer: a nationwide Finnish register study\",\"authors\":\"Panu Aaltonen , Harri Mustonen , Pauli Puolakkainen , Caj Haglund , Katriina Peltola , Hanna Seppänen\",\"doi\":\"10.1016/j.ejso.2025.110139\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Gastric cancer (GC) is associated with a high risk of venous thromboembolism (VTE). We investigated the incidence of VTE before and after a GC diagnosis and its association with overall survival (OS).</div></div><div><h3>Methods</h3><div>We identified GC patients diagnosed in 2011–2016 from the Finnish Cancer Registry, and collected data on healthcare visits, death, and follow-up through the end of 2020. We compared patients based on their cancer stage and the type of treatment they received.</div></div><div><h3>Results</h3><div>We identified 3023 GC patients, amongst whom 995 (32.9 %) underwent gastric surgery, 134 (4.4 %) explorative surgery, and 1894 (62.7 %) no surgery for GC. The cumulative incidence of VTE at 12 and 24 months following GC diagnosis was 5.1 % [95 % confidence interval (CI) 4.31–5.89] and 5.8 % (95 % CI 4.97–6.63), respectively. VTE within one year before GC diagnosis was significantly more frequent amongst no surgery (1.9 %) patients than amongst the gastric (0.8 %) or exploratory surgery only (0.7 %) subgroups (<em>p</em> = 0.018). Median OS amongst patients who had a VTE within one year before a GC diagnosis was 4 months compared to 10 months amongst those who did not (<em>p</em> = 0.001). VTE similarly associated with a worse prognosis, whether occurring within one year before [hazard ratio (HR) 1.69] or after (HR 1.78) a GC diagnosis.</div></div><div><h3>Conclusions</h3><div>VTE associated with a worse survival, whether occurring before or after a GC diagnosis. Pre-diagnosis VTE associated with a lower likelihood of curative-intent surgery presumably due to more advanced GC or VTE-related treatment interference.</div></div>\",\"PeriodicalId\":11522,\"journal\":{\"name\":\"Ejso\",\"volume\":\"51 7\",\"pages\":\"Article 110139\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-05-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ejso\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0748798325005670\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ejso","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0748798325005670","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

胃癌（GC）与静脉血栓栓塞（VTE）的高风险相关。我们调查了胃癌诊断前后静脉血栓栓塞的发生率及其与总生存期（OS）的关系。方法：我们从芬兰癌症登记处（Finnish Cancer Registry）收集2011-2016年诊断的胃癌患者，并收集到2020年底的医疗保健就诊、死亡和随访数据。我们根据患者的癌症阶段和他们接受的治疗类型进行了比较。结果3023例胃癌患者，其中995例（32.9%）行胃手术，134例（4.4%）行探查手术，1894例（62.7%）未行手术。GC诊断后12个月和24个月静脉血栓栓塞的累积发生率分别为5.1%[95%可信区间（CI） 4.31-5.89]和5.8% （95% CI 4.97-6.63）。胃癌诊断前一年内静脉血栓栓塞的发生率在未手术组（1.9%）明显高于胃亚组（0.8%）或仅探查手术组（0.7%）（p = 0.018）。在GC诊断前一年内有静脉血栓栓塞的患者中位生存期为4个月，而没有静脉血栓栓塞的患者中位生存期为10个月（p = 0.001）。静脉血栓栓塞同样与较差的预后相关，无论发生在胃癌诊断前一年[危险比（HR） 1.69]还是之后一年（HR 1.78）。结论svte与较差的生存相关，无论发生在GC诊断之前还是之后。诊断前静脉血栓栓塞与治疗目的手术的可能性较低相关，可能是由于更晚期的GC或静脉血栓栓塞相关的治疗干扰。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Incidence and prognostic role of venous thromboembolism in gastric cancer: a nationwide Finnish register study

Background

Gastric cancer (GC) is associated with a high risk of venous thromboembolism (VTE). We investigated the incidence of VTE before and after a GC diagnosis and its association with overall survival (OS).

Methods

We identified GC patients diagnosed in 2011–2016 from the Finnish Cancer Registry, and collected data on healthcare visits, death, and follow-up through the end of 2020. We compared patients based on their cancer stage and the type of treatment they received.

Results

We identified 3023 GC patients, amongst whom 995 (32.9 %) underwent gastric surgery, 134 (4.4 %) explorative surgery, and 1894 (62.7 %) no surgery for GC. The cumulative incidence of VTE at 12 and 24 months following GC diagnosis was 5.1 % [95 % confidence interval (CI) 4.31–5.89] and 5.8 % (95 % CI 4.97–6.63), respectively. VTE within one year before GC diagnosis was significantly more frequent amongst no surgery (1.9 %) patients than amongst the gastric (0.8 %) or exploratory surgery only (0.7 %) subgroups (p = 0.018). Median OS amongst patients who had a VTE within one year before a GC diagnosis was 4 months compared to 10 months amongst those who did not (p = 0.001). VTE similarly associated with a worse prognosis, whether occurring within one year before [hazard ratio (HR) 1.69] or after (HR 1.78) a GC diagnosis.

Conclusions

VTE associated with a worse survival, whether occurring before or after a GC diagnosis. Pre-diagnosis VTE associated with a lower likelihood of curative-intent surgery presumably due to more advanced GC or VTE-related treatment interference.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.