Frequency, Clinical Pattern and Outcome of Thrombosis in Cancer Patients in Saudi Arabia

Aleem, Aamer; Diab, Abdul Rahman; Alsaleh, Khalid; Algahtani, Farjah H.; Alsaeed, Eyad; Iqbal, Zafar; El-Sherkawy, Mohamed Sherif

doi:10.7314/apjcp.2012.13.4.1311

Cited by 11 publications

(9 citation statements)

References 41 publications

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“…VTE is the most common vascular complication of antineoplastic therapy. Almost half of patients may have additional risk factors for thrombosis (Aleem et al, 2012). The interrelationship between cancer and thrombotic process is well illustrated.…”

Section: Discussionmentioning

confidence: 88%

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Can Megestrol Acetate Induce Thrombosis in Advanced Oncology Patients Receiving Chemotherapy?

Ordu¹,

Pilancı²,

Koksal³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Megestrol acetate (MA) is a steroid origin medicine often used for control of cachexia in oncologic palliative care. Thrombosis is a common problem in oncology patients. One question is whether MA can cause thrombosis. This retrospective, registry-based analysis was therefore conducted to assess thrombotic processes in oncology patients using MA concurrent with chemotherapy. Materials and Methods: Data on oncology patients at the metastatic stage using MA were obtained from the archives of our center. Outcomes of patients were evaluated for thromboembolic events (VTEs) during treatment. Results: Ninety-seven oncology patients with a median age of 62 (33-84) years were included. During the median follow-up of 17 months, 58 (59.8%) died leaving 39 (31.2%) still alive. Median overall survival (OS) was 19 months (6-180). Mean time of MA use was 8.69 months(±3.53), with a median dose of 160mg (range 160-480mg). Eleven VTEs were detected after MA use, 4 of these in pancreatic cancer cases. The patients with thrombosis non-significantly had worse OS, than those without thrombosis (p=0.106). Conclusions: This trial revealed that the 11.3% of all patients developed thrombosis,who had been treated with MA and chemotherapy concomittantly. There was no statistically significant difference regarding to occurrence of thrombotic process, among the patients receiving different chemotherapy regimens with MA concomittantly. Pancreatic cancer seemed to be related to thrombosis rather than MA use.

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Section: Discussionmentioning

confidence: 88%

“…VTE is a major cause of morbidity and mortality in patients with advanced solid tumors (Sorensen et al, 2000;Chew et al, 2006;Khorana et al, 2010). It's well known that VTE increases in patients with cancer (Aleem et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Can Megestrol Acetate Induce Thrombosis in Advanced Oncology Patients Receiving Chemotherapy?

Ordu¹,

Pilancı²,

Koksal³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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show abstract

“…Symptomatic and asymptomatic VTE can occur in a substantional number of patients with cancer. Almost half of the patients may have additional risk factors for thrombosis (Aleem et al, 2012). The interrelationship between cancer and haemostasis is well illustrated.…”

Section: Discussionmentioning

confidence: 89%

A New D-dimer Cutoff Value to Improve the Exclusion of Deep Vein Thrombosis in Cancer Patients

Chen¹,

Li²,

Liu³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Objective: To find a more appropriate alternative to D-dimer cutoff value for the diagnosis of deep vein thrombosis (DVT) in cancer patients. Methods: A total of 711 cancer patients with symptoms suspicious of DVT were included in the study. D-dimer levels were assessed using ELISA. All patients were subjected to imaging procedures. Results: Among 711 patients with cancer, 466 (65.5%) were females and 245 (34.5%) were males, with an average age of 57.3± 13.23 years. The mean age in the DVT group was significantly higher than in the non-DVT group (P<0.05). The D-dimer levels of the DVT group were significantly higher than those of the non-DVT group (P<0.05). The incidence rate of DVT varied significantly according to cancer type (P<0.05). Increasing age and lung cancer were significantly correlated with D-dimer levels (P<0.05), and a one-year increase in age was associated with a 14.28 ng/ml increase in the D-dimer value. The optimal cutoff point for D-dimer was found to be 981 ng/ml, with a sensitivity of 86.4%, specificity of 79.4%, and accuracy of 82.6%. If the D-dimer cutoff point was set to 981ng/ml, the specificity would increase from 61.8% to 85.5% without loss of sensitivity in patients aged 40 years or younger. In patients aged more than 40 years, the new cutoff almost doubled the specificity with slightly reduced sensitivity. Conclusion: In cancer patients, a new cutoff value of 981 ng/ml effectively improved the exclusion of DVT, especially for patients aged more than 40 years.

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“…Venous thromboembolism is a frequent complication of cancer due to hypercoagulable state (10). As one of the VTEs, pulmonary embolism is a common cause of mortality and morbidity in oncologic patients (6).…”

Section: Discussionmentioning

confidence: 99%

Malignancy and Pulmonary Thromboembolism: Comparison of Symptomatic Cases with the Incidental Ones

Baris¹,

Onyilmaz²,

Gumustas³

et al. 2016

West Indian Med J

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Objectives: The use of advanced techniques of computed tomography (CT) was resulted in increased incidentally detected pulmonary embolism in oncology patients undergoing routine cancer staging CT scans. The aim of this study was to compare the symptomatic and incidental pulmonary emboli cases in oncologic patients. Methods: The medical data of the patients diagnosed with pulmonary embolism (ICD: I.26) and had an underlying malignancy were evaluated retrospectively from the hospital records between the years of 2009 and 2013. Right ventricle dilatation findings were evaluated from the thorax CT. Results: There were 38 women (44.2%), 48 men (55.8%), totally 86 patients. The mean age was 61.7 ± 11.9 years and the median duration of follow-up was six months. The most common underlying malignancies were gastrointestinal (29.4%), lung (22.4%), genitourinary (21.2%) and breast cancers (10.6%). Pulmonary thromboembolism was diagnosed incidentally on routine control thorax CT in thirty-nine of the cases (45.3%). When the incidental cases compared to symptomatic ones; no statistically significant difference was found with respect to the type of malignancy, chemotherapy history, presence of metastasis and evidence of septum flattening on thorax CT. The presence of bilaterally thrombus was found as increased in symptomatic cases compared to incidental ones and the difference was statistically significant (p = 0.026). It was found that the RV/LV ratio was significantly higher in symptomatic cases (p = 0.03). Conclusion: A considerable number of pulmonary thromboemboli episodes could be asymptomatic in malignant patients. It is suggested that the sub-massive clinical course and preserved right ventricle functions could be the reason of asymptomatic events.

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Frequency, Clinical Pattern and Outcome of Thrombosis in Cancer Patients in Saudi Arabia

Cited by 11 publications

References 41 publications

Can Megestrol Acetate Induce Thrombosis in Advanced Oncology Patients Receiving Chemotherapy?

Can Megestrol Acetate Induce Thrombosis in Advanced Oncology Patients Receiving Chemotherapy?

A New D-dimer Cutoff Value to Improve the Exclusion of Deep Vein Thrombosis in Cancer Patients

Malignancy and Pulmonary Thromboembolism: Comparison of Symptomatic Cases with the Incidental Ones

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