Venous Thromboembolism in Patients With Colorectal Cancer: Incidence and Effect on Survival

Abstract

The incidence of VTE among colorectal cancer patients was highest in the first 6 months after diagnosis and decreased rapidly thereafter. Metastatic disease and the number of medical comorbidities were the strongest predictors of VTE. Incident VTE reduced survival among patients with local or regional disease, suggesting that, in these patients, VTE may reflect the presence of a biologically more aggressive cancer.

Regional lymph node metastases are a strong risk factor for venous thromboembolism: results from the Vienna Cancer and Thrombosis Study

“…To our knowledge the only studies on this subject are those by the Californian Cancer Registry, which investigated the association between local, regional, and distant stage disease and the occurrence of VTE. 19,[22][23][24][25][26][27] Studies by the Californian Cancer Registry that focused on tumor sites similar to those included in CATS (lung, colon, stomach, pancreatic, breast, and prostate) reported an approximately 2-fold higher risk of VTE in patients with regional disease than in those with local cancer (odds ratios ranging from 1.1 in patients with pancreatic cancer to 2.7 in patients with colon cancer). 19,[22][23][24] Interestingly, in our study the risk of VTE in patients with regional stage cancer was clearly higher.…”

“…5,20,21 Studies of patients in the Californian Cancer Registry investigated the association between VTE and local, regional, and distant disease in a group of different cancer sites 19 and in several single tumor entities. [22][23][24][25][26][27] The risk was highest in patients with metastatic disease, but was also slightly elevated in patients with regional disease, compared to those with localized cancer only. As these studies were based on registry data obtained between 1990 and 1999, other influences on the risk of VTE, such as treatment-related factors, could not be considered.…”

Bevacizumab-Based Therapies in the First-Line Treatment of Metastatic Colorectal Cancer

“…However, a large pooled analysis using patientspecific data from 10 placebo-controlled trials of chemother- apy with and without bevacizumab found no difference in the risk for VTE in patients receiving bevacizumab compared with placebo [68]. VTE remains a significant concern for all patients with mCRC [69]. Nonetheless, bevacizumab does not appear to increase the risk for VTE or the risk for bleeding while on anticoagulation.…”

Impact of Venous Thromboembolism on Mortality of Elderly Medicare Patients with Stage III Colon Cancer

“…The occurrence of thromboembolism can precede the diagnosis of malignant disease by months or years [1][2][3] or can occur subsequent to cancer diagnosis [4,5]. Patients with cancer have an inherently increased risk of developing VTE [6 -9] because of the presence of major risk factors, including cancer-associated hypercoagulable state, vessel wall damage and vessel stasis from direct compression, advanced age, surgical procedures, prolonged immobilization, frequent hospitalization, use of erythropoietic stimulating agents, and the frequent use of indwelling vascular catheters and chemotherapeutic regimens.…”

“…The incidence of VTE in patients with colorectal cancer is highest during the first 6 months after diagnosis and decreases over time [4,[12][13]. VTE incidence varies across cancer stages; the incidence of VTE in colorectal cancer is largely confined to patients with advanced disease [2,4,12,14].…”