Anticoagulant therapy for cancer-associated splanchnic vein thrombosis: Outcomes during a one-year follow-up period

Introduction

The incidence of splanchnic vein thrombosis (SVT) in cancer patients has increased in recent years due to improved survival rates and the widespread use of scheduled radiological tests. However, studies describing the long-term prognosis and benefits of anticoagulant treatment are scarce. The objectives were to describe long-term prognosis and to compare outcomes based on anticoagulant treatment during a one-year follow-up.

Material and methods

This was a retrospective observational study of consecutive patients hospitalized between 2015 and 2020 with a diagnosis of cancer-associated SVT either prior to admission or during hospitalization.

Results

The study included 201 patients, with intra-abdominal tumors (78.2 %) predominating, particularly pancreatic cancer (43.8 %). Portal thrombosis (58.6 %) was the most common type of SVT. Approximately 41.3 % of cases received anticoagulant treatment at the diagnosis of SVT. The overall survival rate at 12 months was 39.7 %. Anticoagulant therapy was associated with a significantly higher accumulated incidence of recanalization and bleeding. However, no differences were found in the survival and recurrence of thrombosis. Tumor thrombus (OR 2.44; CI 95 % 1.32–4.52) and the metastatic status of the oncological disease (OR 3.07; CI 95 % 1.63–5.8) were predictive factors for death.

Conclusions

SVT is a common complication in cancer patients, particularly in those with abdominal tumors. Tumor thrombus and metastatic status were negative prognostic factors. Anticoagulant treatment was associated with a higher rate of recanalization as well as a higher risk of bleeding, without benefits on survival or prevention of thrombosis recurrence.