Cancer and Venous Thromboembolism. Clinical Implications of Strong Association

Prandoni, Paolo

doi:10.1159/000093552

Cited by 4 publications

(3 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Active cancer is the strongest risk factors for VTE recurrences [6,7,14], as well as for mortality. For non-cancer VTE, the risk factors for recurrences are the unprovoked event, the younger age of onset, male sex and VTE unrelated to female hormone [6,7,15,16].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for venous thromboembolism (VTE) recurrences in Thai patients without cancer

Satpanich

Rojnuckarin

2018

Hematology

View full text Add to dashboard Cite

Introduction: Studies in Western countries show that VTE recurrent rates are lower in the presence of a transient provoking factor, older age, female sex and/or hormonal use, while thrombophilia (factor V Leiden or prothrombin mutation) has no predictive role. This study aimed to determine the incidence and risk factors of recurrent VTE in Asian patients. Method: This is a retrospective cohort study in adult VTE patients who were diagnosed during 2004-2014, had no active cancer and followed-up for at least 1 year. Results: There were 198 patients. The mean age was 58.2 ± 17.6 years and 68.2% were female. The diagnoses were deep vein thrombosis (56%), pulmonary embolism (32%) or both (12%). They were provoked by major surgery in 21.7%. Thrombophilia (antiphospholipid syndrome or protein C or protein S deficiency) was found in 11.6%. The recurrent rate during the median follow-up time of 52 months was 2.2 (95% confidence interval [CI] 1.46-3.31) per 100 patient-years. Presence of thrombophilia was independently associated with recurrences with the adjusted hazard ratio (aHR) of 3.52 (95% CI 1.32-9.42, p = 0.01). There were 144 patients who discontinued anticoagulants. During the median time of 55 months after stopping anticoagulants, the recurrent rate was 4.3 per 100 patient-years. Thrombophilia was associated with recurrences with aHR of 4.00 (95% CI 1.42-11.31, p = 0.01), while male sex, younger age, provoking conditions and hormone use showed no significant association. Conclusion: VTE recurrent rate in Asians is comparable to Caucasians, but thrombophilia is the strongest risk factor.

show abstract

Section: Introductionmentioning

confidence: 99%

Risk factors for venous thromboembolism (VTE) recurrences in Thai patients without cancer

Satpanich

Rojnuckarin

2018

Hematology

View full text Add to dashboard Cite

show abstract

“…In 1865 Trousseau reported that thrombophlebitis was often associated with underlying cancer [1]. This early report has been followed by numerous studies that have focused on two separate aspects of the problem: the prevention and management of venous thromboembolic events (VTE) in patients with cancer [2–7] and the association between idiopathic VTE and the presence of occult cancer [8–10]. This second aspect of the appearance of cancer after unexplained VTE has been particularly troublesome and has led to questions concerning appropriate screening methodology to detect a possible occult neoplasm.…”

Section: Introductionmentioning

confidence: 99%

Venous thromboembolic events and organ‐specific occult cancers: a review and meta‐analysis

Iodice

Gandini

Löhr

et al. 2008

Journal of Thrombosis and Haemostasis

View full text Add to dashboard Cite

To cite this article: Iodice S, Gandini S, Lö hr M, Lowenfels AB, Maisonneuve P. Venous thromboembolic events and organ-specific occult cancers: a review and meta-analysis. J Thromb Haemost 2008; 6: 781-8. Summary. Background: Despite a recognized association between venous thromboembolic events (VTE) and cancer, little is known about the strength and the features of this association. We performed a meta-analysis in order to clarify this issue. Methods: We retrieved data from 40 reports published between 1982 and 2007: 12 contained cancer risk estimates for patients with either idiopathic or secondary VTE vs. subjects without VTE and 17 for patients with idiopathic vs. secondary VTE. We also pooled risk estimates from four cohort studies to assess the association between VTE and specific forms of cancer and conducted a proportional incidence study, based on the remaining 28 reports, which did not provide risk estimates. Results: The pooled relative risk (RR) of cancer was 3.2 [95% confidence interval (95% CI) 2.4-4.5] for patients with any form of VTE vs. no VTE, 2.7 (95% CI 1.9-3.9) for patients with idiopathic vs. no VTE and 3.8 (95% CI 2.6-5.4) for patients with idiopathic vs. secondary VTE. In the pooled cohort studies, RRs for VTE vs. no VTE were significantly elevated for cancers of the ovary (RR 7.0), pancreas (RR 6.1), liver (RR 5.6), blood (4.2), brain (RR 3.8), kidney (RR 3.4), lung (3.1), colon (2.9), and esophagus (2.1). In the proportional incidence study, cancers of the pancreas, colon, and blood were significantly more frequently observed than in the general population. Conclusions: Overall we found a 3-fold excess risk of occult cancer in patients with VTE. The risk varies according to tumor site and is highest for cancers of the ovary, pancreas, and liver.

show abstract

“…Concerns of dehydration have resulted in the advice to avoid alcoholic beverages during long-haul flight. This is based on the assumption that dehydration may increase the risk of thrombosis, which indeed is supported by reports in other clinical conditions involving dehydration (4)(5)(6).…”

mentioning

confidence: 65%