Occult cancer in patients with bilateral deep-vein thrombosis

Rance, A; Emmerich, Joseph; Guedj, C; Jn, Fiessinger

doi:10.1016/s0140-6736(05)64210-9

Cited by 75 publications

(45 citation statements)

References 5 publications

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“…In the past years very few studies have investigated possible associations between anatomic topography of DVT and malignancy. A retrospective small trial reported a 30% prevalence of malignancy in patients with idiopathic bilateral DVT, 13 while Bura and colleagues, in a prospective series of 100 patients, found that bilateral DVT was a significant risk indicator of malignancy and that cancer was present in 45% of such cases.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and management of cancer-associated acute venous thromboembolism: findings from the MASTER Registry

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics and management of cancer-associated acute venous thromboembolism: findings from the MASTER Registry

et al. 2008

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“…Bilateral DVT seems to be more common among cancer patients than in noncancer patients. [39][40][41] A recent study by Imberti et al showed that rates of symptomatic bilateral lower limb DVT, symptomatic iliocaval thrombosis, and upper limb DVT were higher in cancer patients compared with patients free from cancer (8.5% vs 4.6%, 22.6% vs 14.0%, and 9.9% vs 4.8%, respectively). 6 In this study, rates of PE and symptomatic proximal DVT were similar.…”

Section: Blood 5 September 2013 X Volume 122 Number 10 Cancer-assocmentioning

confidence: 99%

Epidemiology of cancer-associated venous thrombosis

Timp

Brækkan

Versteeg

et al. 2013

Blood

993

745

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Cancer-associated venous thrombosis is a common condition, although the reported incidence varies widely between studies depending on patient population, start and duration of follow-up, and the method of detecting and reporting thrombotic events. Furthermore, as cancer is a heterogeneous disease, the risk of venous thrombosis depends on cancer types and stages, treatment measures, and patient-related factors. In general, cancer patients with venous thrombosis do not fare well and have an increased mortality compared with cancer patients without. This may be explained by the more aggressive type of malignancies associated with this condition. It is hypothesized that thromboprophylaxis in cancer patients might improve prognosis and quality of life by preventing thrombotic events. However, anticoagulant treatment leads to increased bleeding, particularly in this patient group, so in case of proven benefit of thromboprophylaxis, only patients with a high risk of venous thrombosis should be considered. This review describes the literature on incidence of and risk factors for cancer-associated venous thrombosis, with the aim to provide a basis for identification of high-risk patients and for further development and refinement of prediction models. Furthermore, knowledge on risk factors for cancer-related venous thrombosis may enhance the understanding of the pathophysiology of thrombosis in these patients.

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“…Thus, it would be interesting to know additional variables that may be associated with an increased incidence of hidden cancer. There is some evidence that patients with recurrent VTE [5], bilateral DVT [18], upperextremity DVT [19] or increased D-dimer levels at presentation [20] are at an increased risk. Besides, there is some controversy over the role of patient age, with some reports finding occult cancer most commonly in the younger, and others in the elderly [21].…”

Section: Venous Thromboembolism and Hidden Cancer 253mentioning

confidence: 99%

Clinical outcome in patients with venous thromboembolism and hidden cancer: findings from the RIETE Registry

et al. 2008

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To cite this article: Trujillo-Santos J, Prandoni P, Rivron-Guillot K, Romá n P, Sá nchez R, Tiberio G, Monreal M, the RIETE Investigators. Clinical outcome in patients with venous thromboembolism and hidden cancer: findings from the RIETE Registry. J Thromb Haemost 2008; 6: 251-5.See also Sørensen HT, Johnsen SP. Venous thromboembolism and subsequent short-term risk of an occult cancer. This issue, pp 249-50.Summary. Introduction: Although extensive screening in patients with venous thromboembolism (VTE) may result in early identification of hidden cancer, it is unknown whether the prognosis of these patients may be favorably influenced. Patients and methods: RIETE is an ongoing, prospective registry of consecutive patients with objectively confirmed, symptomatic, acute VTE. We compared the 3-month outcome of patients with hidden cancer with that in patients in whom no symptoms of cancer were noted. Results: Of 17 475 patients with acute VTE, 2852 (16%) had cancer diagnosed before VTE or during admission. Hidden cancer was detected in 178 (1.2%) of the remaining 14 623 patients. The most common sites were lung, prostate, colorectum, or hematologic, and 51% had metastases. As compared with patients in whom no symptoms of cancer were noted, those with hidden cancer had an increased incidence of recurrent VTE (11.4% vs. 2.1%; P < 0.001), major bleeding (5.1% vs. 2.1%; P = 0.007), and mortality (20% vs. 5.4%; P < 0.001). In the multivariate analysis, patients aged 60-75 years [odds ratio 1.8; 95% CI 1.2-2.7], with idiopathic VTE (odds ratio 3.0; 95% CI 2.2-4.2), with bilateral thrombosis (odds ratio 2.3; 95% CI 1.3-4.1) or with anemia (odds ratio 1.9; 95% CI 1.4-2.6) were at an increased risk for hidden cancer. Conclusions: VTE patients with hidden cancer have an increased incidence of recurrences, major bleeding or death during the first 3 months of therapy. With four simple, easily obtainable variables, it is possible to identify a subgroup of VTE patients with a higher risk for hidden cancer.

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Occult cancer in patients with bilateral deep-vein thrombosis

Cited by 75 publications

References 5 publications

Clinical characteristics and management of cancer-associated acute venous thromboembolism: findings from the MASTER Registry

Clinical characteristics and management of cancer-associated acute venous thromboembolism: findings from the MASTER Registry

Epidemiology of cancer-associated venous thrombosis

Clinical outcome in patients with venous thromboembolism and hidden cancer: findings from the RIETE Registry

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