Venous thromboembolism in cancer patients: report of baseline data from the multicentre, prospective Cancer-VTE Registry

Abstract

Background The Cancer-VTE Registry evaluates the occurrence and management of venous thromboembolism in Japanese participants with major solid tumors. Using Registry data, we evaluated the frequency of concurrent venous thromboembolism in cancer patients prior to treatment initiation by cancer type. Methods The Cancer-VTE Registry is an ongoing (March 2017–September 2020) prospective cohort study using a nationwide, multicentre clinical registry. Participants aged ≥20 years with colorectal, lung, stomach, pancreatic, breast or gynecologic cancer, confirmed staging, ≥6 months life expectancy post-registration and who had undergone venous thromboembolism screening were managed with routine clinical care. Venous thromboembolism frequency at registration was evaluated. Results Of 9735 participants, 571 (5.9%) had venous thromboembolism at baseline, including asymptomatic [5.5% (n = 540)] and symptomatic venous thromboembolism [0.3% (n = 31)]. Most participants with venous thromboembolism (n = 506, 5.2%) had deep vein thrombosis only; 65 (0.7%) had pulmonary embolism with/without deep vein thrombosis. The prevalence of distal and proximal deep vein thrombosis was 4.8% (n = 466) and 0.9% (n = 83), respectively. The highest prevalence of venous thromboembolism was for pancreatic cancer (8.5%) and the lowest for breast cancer (2.0%). Venous thromboembolism prevalence increased as cancer stage advanced. Conclusions Although there was a marked difference in venous thromboembolism by cancer type, the data suggest that cancer stage is an important risk factor for venous thromboembolism. Thus, metastasis seems a critical risk factor for venous thromboembolism. This is the first demonstration of venous thromboembolism prevalence and risk factors in Japanese cancer patients prior to treatment. Trial registration UMIN000024942.

Correlation between clinicopathological characteristics of lung adenocarcinoma and the risk of venous thromboembolism

“… 20 , 21 VTE events mostly occur during hospitalization, including the perioperative period, and subsequent examinations or treatments, which support that hospitalization is an independent risk factor for VTE. 22 , 23 , 24 In addition, most VTE events in this study were found in the lower extremities which is in agreement with previously reported studies. 25 , 26 Therefore, we have the same recommendations as previous studies, 25 which is that lower‐extremity ultrasonography is probably required for screening post‐surgical DVT cases during hospitalization.…”

“…VTE is a major source of postoperative morbidity and mortality for patients undergoing thoracic surgery 20,21 . VTE events mostly occur during hospitalization, including the perioperative period, and subsequent examinations or treatments, which support that hospitalization is an independent risk factor for VTE 22–24 . In addition, most VTE events in this study were found in the lower extremities which is in agreement with previously reported studies 25,26 .…”

Incidental pulmonary embolism in oncologic patients—a systematic review and meta-analysis

“…PE has a multifactorial etiology with many independent risk factors associated with venous thromboembolism (VTE), such as surgery, trauma, hospitalization, malignant neoplasm with or without chemotherapy, and the use of central venous catheters [26,27].…”

“…Noteworthy, VTE is an independent prognostic factor of mortality in cancer patients. Thus, cancer patients with VTE have a shorter overall survival than cancer patients without VTE at the same tumor stage with the same treatment [26,28].…”

Incidence and Related Factors for Low-Extremity Deep Vein Thrombosis in Breast Cancer Patients Who Underwent Surgical Resection: What Do We Know and What Should We Care

“…According to previous studies, DVT rarely occurs in patients with various cancers, such as breast, prostate, and colorectal cancers (10,18,26,30,36). A study shows that in 9,735 patients with cancer (such as colorectal, lung, stomach, pancreatic, breast, and gynecologic cancers), the DVT incidence is 5.2% in Japan (37). In terms of patients with breast cancer who underwent surgery, another study exhibits that the 2-month cumulative DVT incidence is ∼0.15% in the USA (26).…”