The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site

Isabelle Mahé, Jean Chidiac, Laurent Bertoletti, Carme Font, Javier Trujillo-Santos, Marisa Peris, Cristina Pérez Ductor, Santiago Nieto, Elvira Grandone, Manuel Monreal, M. A. Aibar, J. I. Arcelus, A. Ballaz, R. Barba, M. Barrón, B. Barrón-Andrés, J. Bascuñana, A. Blanco-Molina, T. Bueso, I. Casado & 120 others A. Culla, J. de Miguel, J. Del Toro, J. A. Díaz Peromingo, C. Falgá, C. Fernández-Capitán, C. Font, L. Font, P. Gallego, F. García-Bragado, P. García-Brotons, V. Gómez, J. González, E. Grau, A. Grimón, L. Guirado, J. Gutiérrez, G. Hernández, L. Hernández-Blasco, V. Isern, L. Jara-Palomares, M. J. Jaras, D. Jiménez, B. Lacruz, R. Lecumberri, J. L. Lobo, L. López-Jiménez, R. López-Reyes, J. B. López-Sáez, M. A. Lorente, A. Lorenzo, O. Madridano, P. J. Marchena, J. M. Martín-Antorán, F. Martín-Martos, M. Monreal, M. V. Morales, D. Nauffal, J. A. Nieto, S. Nieto, M. J. Núñez, S. Otalora, R. Otero, B. Pagán, J. M. Pedrajas, C. Pérez, G. Pérez, M. L. Peris, J. A. Porras, José Luis Ramírez, O. Reig, J. A. Riera, A. Rivas, M. A. Rodríguez-Dávila, V. Rosa, P. Ruiz-Artacho, N. Ruiz-Giménez, C. Ruiz-Martínez, A. Sampériz, C. Sala, O. Sanz, S. Soler, Bernardo Sopeña, Jose I. Suarez, J. M. Suriñach, G. Tiberio, C. Tolosa, J. Trujillo-Santos, F. Uresandi, R. Valle, J. Vela, J. Villalta, P. C. Malfante, P. Verhamme, P. Wells, J. Hirmerova, R. Malý, T. Tomko, E. Salgado, L. Bertoletti, A. Bura-Riviere, Dominique Farge-Bancel, A. Hij, I. Mahé, A. Merah, M. Papadakis, A. Braester, B. Brenner, I. Tzoran, A. Apollonio, G. Barillari, Giampiero Candeloro, M. Ciammaichella, P. Di Micco, P. Ferrazzi, Elvira Grandone, Gianfranco Lessiani, C. Lodigiani, D. Mastroiacovo, F. Pace, M. Pinelli, P. Prandoni, L. Rota, E. Tiraferri, A. Tufano, A. Visonà, A. Belovs, A. Skride, M. Moreira, J. L. Ribeiro, M. S. Sousa, M. Bosevski, M. Zdraveska, A. Alatri, H. Bounameaux, L. Calanca, L. Mazzolai, J. C. Serrano, Hervé Decousus, Abilio Reis

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background We hypothesized that the clinical course of venous thromboembolism in patients with active cancer may differ according to the specificities of primary tumor site. Aim and Methods We used data from RIETE (international registry of patients with venous thromboembolism) to compare the clinical venous thromboembolism-related outcomes during the course of anticoagulation in patients with one of the 4 more frequent cancers (breast, prostate, colorectal, or lung cancer). Results As of September 2014, 3947 cancer patients were recruited, of whom 938 had breast, 629 prostate, 1189 colorectal, and 1191 lung cancer. Overall, 55% had metastatic disease (42%, 36%, 53%, and 72%, respectively). During the course of anticoagulant therapy (mean duration, 139 days), the rate of thromboembolic recurrences was similar to the rate of major bleeding in patients with breast (5.6 [95% confidence interval (CI), 3.8-8.1] vs 4.1 [95% CI, 2.7-5.9] events per 100 patient-years) or colorectal cancer (10 [95% CI, 7.6-13] vs 12 [95% CI, 9.4-15] per 100 patient-years). In contrast, in patients with prostate cancer, the rate of venous thromboembolic recurrences was half the rate of major bleeding (6.9 [95% CI, 4.4-10] vs 13 [95% CI, 9.2-17] events per 100 patient-years), whereas in those with lung cancer, the rate of thromboembolic recurrences was twofold higher than the rate of major bleeding (27 [95% CI, 22-23] vs 11 [95% CI, 8.6-15] per 100 patient-years). Conclusions Significant differences in the clinical profile of venous thromboembolic-related outcomes were observed according to the site of cancer. These findings suggest the development of cancer-specific anticoagulant strategies as an area for further research.

Original languageEnglish
Pages (from-to)337-347
Number of pages11
JournalAmerican Journal of Medicine
Volume130
Issue number3
DOIs
Publication statusPublished - Mar 1 2017

Fingerprint

Venous Thromboembolism
Confidence Intervals
Neoplasms
Lung Neoplasms
Prostatic Neoplasms
Hemorrhage
Recurrence
Anticoagulants
Colorectal Neoplasms
Breast
Registries
Prostate
Breast Neoplasms

Keywords

  • Anticoagulant therapy
  • Bleeding
  • Cancer
  • Mortality
  • Recurrences
  • Venous thromboembolism

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Mahé, I., Chidiac, J., Bertoletti, L., Font, C., Trujillo-Santos, J., Peris, M., ... Reis, A. (2017). The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site. American Journal of Medicine, 130(3), 337-347. https://doi.org/10.1016/j.amjmed.2016.10.017

The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site. / Mahé, Isabelle; Chidiac, Jean; Bertoletti, Laurent; Font, Carme; Trujillo-Santos, Javier; Peris, Marisa; Pérez Ductor, Cristina; Nieto, Santiago; Grandone, Elvira; Monreal, Manuel; Aibar, M. A.; Arcelus, J. I.; Ballaz, A.; Barba, R.; Barrón, M.; Barrón-Andrés, B.; Bascuñana, J.; Blanco-Molina, A.; Bueso, T.; Casado, I.; Culla, A.; de Miguel, J.; Del Toro, J.; Díaz Peromingo, J. A.; Falgá, C.; Fernández-Capitán, C.; Font, C.; Font, L.; Gallego, P.; García-Bragado, F.; García-Brotons, P.; Gómez, V.; González, J.; Grau, E.; Grimón, A.; Guirado, L.; Gutiérrez, J.; Hernández, G.; Hernández-Blasco, L.; Isern, V.; Jara-Palomares, L.; Jaras, M. J.; Jiménez, D.; Lacruz, B.; Lecumberri, R.; Lobo, J. L.; López-Jiménez, L.; López-Reyes, R.; López-Sáez, J. B.; Lorente, M. A.; Lorenzo, A.; Madridano, O.; Marchena, P. J.; Martín-Antorán, J. M.; Martín-Martos, F.; Monreal, M.; Morales, M. V.; Nauffal, D.; Nieto, J. A.; Nieto, S.; Núñez, M. J.; Otalora, S.; Otero, R.; Pagán, B.; Pedrajas, J. M.; Pérez, C.; Pérez, G.; Peris, M. L.; Porras, J. A.; Luis Ramírez, José; Reig, O.; Riera, J. A.; Rivas, A.; Rodríguez-Dávila, M. A.; Rosa, V.; Ruiz-Artacho, P.; Ruiz-Giménez, N.; Ruiz-Martínez, C.; Sampériz, A.; Sala, C.; Sanz, O.; Soler, S.; Sopeña, Bernardo; Suarez, Jose I.; Suriñach, J. M.; Tiberio, G.; Tolosa, C.; Trujillo-Santos, J.; Uresandi, F.; Valle, R.; Vela, J.; Villalta, J.; Malfante, P. C.; Verhamme, P.; Wells, P.; Hirmerova, J.; Malý, R.; Tomko, T.; Salgado, E.; Bertoletti, L.; Bura-Riviere, A.; Farge-Bancel, Dominique; Hij, A.; Mahé, I.; Merah, A.; Papadakis, M.; Braester, A.; Brenner, B.; Tzoran, I.; Apollonio, A.; Barillari, G.; Candeloro, Giampiero; Ciammaichella, M.; Di Micco, P.; Ferrazzi, P.; Grandone, Elvira; Lessiani, Gianfranco; Lodigiani, C.; Mastroiacovo, D.; Pace, F.; Pinelli, M.; Prandoni, P.; Rota, L.; Tiraferri, E.; Tufano, A.; Visonà, A.; Belovs, A.; Skride, A.; Moreira, M.; Ribeiro, J. L.; Sousa, M. S.; Bosevski, M.; Zdraveska, M.; Alatri, A.; Bounameaux, H.; Calanca, L.; Mazzolai, L.; Serrano, J. C.; Decousus, Hervé; Reis, Abilio.

In: American Journal of Medicine, Vol. 130, No. 3, 01.03.2017, p. 337-347.

Research output: Contribution to journalArticle

Mahé, I, Chidiac, J, Bertoletti, L, Font, C, Trujillo-Santos, J, Peris, M, Pérez Ductor, C, Nieto, S, Grandone, E, Monreal, M, Aibar, MA, Arcelus, JI, Ballaz, A, Barba, R, Barrón, M, Barrón-Andrés, B, Bascuñana, J, Blanco-Molina, A, Bueso, T, Casado, I, Culla, A, de Miguel, J, Del Toro, J, Díaz Peromingo, JA, Falgá, C, Fernández-Capitán, C, Font, C, Font, L, Gallego, P, García-Bragado, F, García-Brotons, P, Gómez, V, González, J, Grau, E, Grimón, A, Guirado, L, Gutiérrez, J, Hernández, G, Hernández-Blasco, L, Isern, V, Jara-Palomares, L, Jaras, MJ, Jiménez, D, Lacruz, B, Lecumberri, R, Lobo, JL, López-Jiménez, L, López-Reyes, R, López-Sáez, JB, Lorente, MA, Lorenzo, A, Madridano, O, Marchena, PJ, Martín-Antorán, JM, Martín-Martos, F, Monreal, M, Morales, MV, Nauffal, D, Nieto, JA, Nieto, S, Núñez, MJ, Otalora, S, Otero, R, Pagán, B, Pedrajas, JM, Pérez, C, Pérez, G, Peris, ML, Porras, JA, Luis Ramírez, J, Reig, O, Riera, JA, Rivas, A, Rodríguez-Dávila, MA, Rosa, V, Ruiz-Artacho, P, Ruiz-Giménez, N, Ruiz-Martínez, C, Sampériz, A, Sala, C, Sanz, O, Soler, S, Sopeña, B, Suarez, JI, Suriñach, JM, Tiberio, G, Tolosa, C, Trujillo-Santos, J, Uresandi, F, Valle, R, Vela, J, Villalta, J, Malfante, PC, Verhamme, P, Wells, P, Hirmerova, J, Malý, R, Tomko, T, Salgado, E, Bertoletti, L, Bura-Riviere, A, Farge-Bancel, D, Hij, A, Mahé, I, Merah, A, Papadakis, M, Braester, A, Brenner, B, Tzoran, I, Apollonio, A, Barillari, G, Candeloro, G, Ciammaichella, M, Di Micco, P, Ferrazzi, P, Grandone, E, Lessiani, G, Lodigiani, C, Mastroiacovo, D, Pace, F, Pinelli, M, Prandoni, P, Rota, L, Tiraferri, E, Tufano, A, Visonà, A, Belovs, A, Skride, A, Moreira, M, Ribeiro, JL, Sousa, MS, Bosevski, M, Zdraveska, M, Alatri, A, Bounameaux, H, Calanca, L, Mazzolai, L, Serrano, JC, Decousus, H & Reis, A 2017, 'The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site', American Journal of Medicine, vol. 130, no. 3, pp. 337-347. https://doi.org/10.1016/j.amjmed.2016.10.017
Mahé I, Chidiac J, Bertoletti L, Font C, Trujillo-Santos J, Peris M et al. The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site. American Journal of Medicine. 2017 Mar 1;130(3):337-347. https://doi.org/10.1016/j.amjmed.2016.10.017
Mahé, Isabelle ; Chidiac, Jean ; Bertoletti, Laurent ; Font, Carme ; Trujillo-Santos, Javier ; Peris, Marisa ; Pérez Ductor, Cristina ; Nieto, Santiago ; Grandone, Elvira ; Monreal, Manuel ; Aibar, M. A. ; Arcelus, J. I. ; Ballaz, A. ; Barba, R. ; Barrón, M. ; Barrón-Andrés, B. ; Bascuñana, J. ; Blanco-Molina, A. ; Bueso, T. ; Casado, I. ; Culla, A. ; de Miguel, J. ; Del Toro, J. ; Díaz Peromingo, J. A. ; Falgá, C. ; Fernández-Capitán, C. ; Font, C. ; Font, L. ; Gallego, P. ; García-Bragado, F. ; García-Brotons, P. ; Gómez, V. ; González, J. ; Grau, E. ; Grimón, A. ; Guirado, L. ; Gutiérrez, J. ; Hernández, G. ; Hernández-Blasco, L. ; Isern, V. ; Jara-Palomares, L. ; Jaras, M. J. ; Jiménez, D. ; Lacruz, B. ; Lecumberri, R. ; Lobo, J. L. ; López-Jiménez, L. ; López-Reyes, R. ; López-Sáez, J. B. ; Lorente, M. A. ; Lorenzo, A. ; Madridano, O. ; Marchena, P. J. ; Martín-Antorán, J. M. ; Martín-Martos, F. ; Monreal, M. ; Morales, M. V. ; Nauffal, D. ; Nieto, J. A. ; Nieto, S. ; Núñez, M. J. ; Otalora, S. ; Otero, R. ; Pagán, B. ; Pedrajas, J. M. ; Pérez, C. ; Pérez, G. ; Peris, M. L. ; Porras, J. A. ; Luis Ramírez, José ; Reig, O. ; Riera, J. A. ; Rivas, A. ; Rodríguez-Dávila, M. A. ; Rosa, V. ; Ruiz-Artacho, P. ; Ruiz-Giménez, N. ; Ruiz-Martínez, C. ; Sampériz, A. ; Sala, C. ; Sanz, O. ; Soler, S. ; Sopeña, Bernardo ; Suarez, Jose I. ; Suriñach, J. M. ; Tiberio, G. ; Tolosa, C. ; Trujillo-Santos, J. ; Uresandi, F. ; Valle, R. ; Vela, J. ; Villalta, J. ; Malfante, P. C. ; Verhamme, P. ; Wells, P. ; Hirmerova, J. ; Malý, R. ; Tomko, T. ; Salgado, E. ; Bertoletti, L. ; Bura-Riviere, A. ; Farge-Bancel, Dominique ; Hij, A. ; Mahé, I. ; Merah, A. ; Papadakis, M. ; Braester, A. ; Brenner, B. ; Tzoran, I. ; Apollonio, A. ; Barillari, G. ; Candeloro, Giampiero ; Ciammaichella, M. ; Di Micco, P. ; Ferrazzi, P. ; Grandone, Elvira ; Lessiani, Gianfranco ; Lodigiani, C. ; Mastroiacovo, D. ; Pace, F. ; Pinelli, M. ; Prandoni, P. ; Rota, L. ; Tiraferri, E. ; Tufano, A. ; Visonà, A. ; Belovs, A. ; Skride, A. ; Moreira, M. ; Ribeiro, J. L. ; Sousa, M. S. ; Bosevski, M. ; Zdraveska, M. ; Alatri, A. ; Bounameaux, H. ; Calanca, L. ; Mazzolai, L. ; Serrano, J. C. ; Decousus, Hervé ; Reis, Abilio. / The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site. In: American Journal of Medicine. 2017 ; Vol. 130, No. 3. pp. 337-347.
@article{060bf986d2974505a4328c9bee412ec1,
title = "The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site",
abstract = "Background We hypothesized that the clinical course of venous thromboembolism in patients with active cancer may differ according to the specificities of primary tumor site. Aim and Methods We used data from RIETE (international registry of patients with venous thromboembolism) to compare the clinical venous thromboembolism-related outcomes during the course of anticoagulation in patients with one of the 4 more frequent cancers (breast, prostate, colorectal, or lung cancer). Results As of September 2014, 3947 cancer patients were recruited, of whom 938 had breast, 629 prostate, 1189 colorectal, and 1191 lung cancer. Overall, 55{\%} had metastatic disease (42{\%}, 36{\%}, 53{\%}, and 72{\%}, respectively). During the course of anticoagulant therapy (mean duration, 139 days), the rate of thromboembolic recurrences was similar to the rate of major bleeding in patients with breast (5.6 [95{\%} confidence interval (CI), 3.8-8.1] vs 4.1 [95{\%} CI, 2.7-5.9] events per 100 patient-years) or colorectal cancer (10 [95{\%} CI, 7.6-13] vs 12 [95{\%} CI, 9.4-15] per 100 patient-years). In contrast, in patients with prostate cancer, the rate of venous thromboembolic recurrences was half the rate of major bleeding (6.9 [95{\%} CI, 4.4-10] vs 13 [95{\%} CI, 9.2-17] events per 100 patient-years), whereas in those with lung cancer, the rate of thromboembolic recurrences was twofold higher than the rate of major bleeding (27 [95{\%} CI, 22-23] vs 11 [95{\%} CI, 8.6-15] per 100 patient-years). Conclusions Significant differences in the clinical profile of venous thromboembolic-related outcomes were observed according to the site of cancer. These findings suggest the development of cancer-specific anticoagulant strategies as an area for further research.",
keywords = "Anticoagulant therapy, Bleeding, Cancer, Mortality, Recurrences, Venous thromboembolism",
author = "Isabelle Mah{\'e} and Jean Chidiac and Laurent Bertoletti and Carme Font and Javier Trujillo-Santos and Marisa Peris and {P{\'e}rez Ductor}, Cristina and Santiago Nieto and Elvira Grandone and Manuel Monreal and Aibar, {M. A.} and Arcelus, {J. I.} and A. Ballaz and R. Barba and M. Barr{\'o}n and B. Barr{\'o}n-Andr{\'e}s and J. Bascu{\~n}ana and A. Blanco-Molina and T. Bueso and I. Casado and A. Culla and {de Miguel}, J. and {Del Toro}, J. and {D{\'i}az Peromingo}, {J. A.} and C. Falg{\'a} and C. Fern{\'a}ndez-Capit{\'a}n and C. Font and L. Font and P. Gallego and F. Garc{\'i}a-Bragado and P. Garc{\'i}a-Brotons and V. G{\'o}mez and J. Gonz{\'a}lez and E. Grau and A. Grim{\'o}n and L. Guirado and J. Guti{\'e}rrez and G. Hern{\'a}ndez and L. Hern{\'a}ndez-Blasco and V. Isern and L. Jara-Palomares and Jaras, {M. J.} and D. Jim{\'e}nez and B. Lacruz and R. Lecumberri and Lobo, {J. L.} and L. L{\'o}pez-Jim{\'e}nez and R. L{\'o}pez-Reyes and L{\'o}pez-S{\'a}ez, {J. B.} and Lorente, {M. A.} and A. Lorenzo and O. Madridano and Marchena, {P. J.} and Mart{\'i}n-Antor{\'a}n, {J. M.} and F. Mart{\'i}n-Martos and M. Monreal and Morales, {M. V.} and D. Nauffal and Nieto, {J. A.} and S. Nieto and N{\'u}{\~n}ez, {M. J.} and S. Otalora and R. Otero and B. Pag{\'a}n and Pedrajas, {J. M.} and C. P{\'e}rez and G. P{\'e}rez and Peris, {M. L.} and Porras, {J. A.} and {Luis Ram{\'i}rez}, Jos{\'e} and O. Reig and Riera, {J. A.} and A. Rivas and Rodr{\'i}guez-D{\'a}vila, {M. A.} and V. Rosa and P. Ruiz-Artacho and N. Ruiz-Gim{\'e}nez and C. Ruiz-Mart{\'i}nez and A. Samp{\'e}riz and C. Sala and O. Sanz and S. Soler and Bernardo Sope{\~n}a and Suarez, {Jose I.} and Suri{\~n}ach, {J. M.} and G. Tiberio and C. Tolosa and J. Trujillo-Santos and F. Uresandi and R. Valle and J. Vela and J. Villalta and Malfante, {P. C.} and P. Verhamme and P. Wells and J. Hirmerova and R. Mal{\'y} and T. Tomko and E. Salgado and L. Bertoletti and A. Bura-Riviere and Dominique Farge-Bancel and A. Hij and I. Mah{\'e} and A. Merah and M. Papadakis and A. Braester and B. Brenner and I. Tzoran and A. Apollonio and G. Barillari and Giampiero Candeloro and M. Ciammaichella and {Di Micco}, P. and P. Ferrazzi and Elvira Grandone and Gianfranco Lessiani and C. Lodigiani and D. Mastroiacovo and F. Pace and M. Pinelli and P. Prandoni and L. Rota and E. Tiraferri and A. Tufano and A. Vison{\`a} and A. Belovs and A. Skride and M. Moreira and Ribeiro, {J. L.} and Sousa, {M. S.} and M. Bosevski and M. Zdraveska and A. Alatri and H. Bounameaux and L. Calanca and L. Mazzolai and Serrano, {J. C.} and Herv{\'e} Decousus and Abilio Reis",
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month = "3",
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doi = "10.1016/j.amjmed.2016.10.017",
language = "English",
volume = "130",
pages = "337--347",
journal = "American Journal of Medicine",
issn = "0002-9343",
publisher = "Elsevier Inc.",
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TY - JOUR

T1 - The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site

AU - Mahé, Isabelle

AU - Chidiac, Jean

AU - Bertoletti, Laurent

AU - Font, Carme

AU - Trujillo-Santos, Javier

AU - Peris, Marisa

AU - Pérez Ductor, Cristina

AU - Nieto, Santiago

AU - Grandone, Elvira

AU - Monreal, Manuel

AU - Aibar, M. A.

AU - Arcelus, J. I.

AU - Ballaz, A.

AU - Barba, R.

AU - Barrón, M.

AU - Barrón-Andrés, B.

AU - Bascuñana, J.

AU - Blanco-Molina, A.

AU - Bueso, T.

AU - Casado, I.

AU - Culla, A.

AU - de Miguel, J.

AU - Del Toro, J.

AU - Díaz Peromingo, J. A.

AU - Falgá, C.

AU - Fernández-Capitán, C.

AU - Font, C.

AU - Font, L.

AU - Gallego, P.

AU - García-Bragado, F.

AU - García-Brotons, P.

AU - Gómez, V.

AU - González, J.

AU - Grau, E.

AU - Grimón, A.

AU - Guirado, L.

AU - Gutiérrez, J.

AU - Hernández, G.

AU - Hernández-Blasco, L.

AU - Isern, V.

AU - Jara-Palomares, L.

AU - Jaras, M. J.

AU - Jiménez, D.

AU - Lacruz, B.

AU - Lecumberri, R.

AU - Lobo, J. L.

AU - López-Jiménez, L.

AU - López-Reyes, R.

AU - López-Sáez, J. B.

AU - Lorente, M. A.

AU - Lorenzo, A.

AU - Madridano, O.

AU - Marchena, P. J.

AU - Martín-Antorán, J. M.

AU - Martín-Martos, F.

AU - Monreal, M.

AU - Morales, M. V.

AU - Nauffal, D.

AU - Nieto, J. A.

AU - Nieto, S.

AU - Núñez, M. J.

AU - Otalora, S.

AU - Otero, R.

AU - Pagán, B.

AU - Pedrajas, J. M.

AU - Pérez, C.

AU - Pérez, G.

AU - Peris, M. L.

AU - Porras, J. A.

AU - Luis Ramírez, José

AU - Reig, O.

AU - Riera, J. A.

AU - Rivas, A.

AU - Rodríguez-Dávila, M. A.

AU - Rosa, V.

AU - Ruiz-Artacho, P.

AU - Ruiz-Giménez, N.

AU - Ruiz-Martínez, C.

AU - Sampériz, A.

AU - Sala, C.

AU - Sanz, O.

AU - Soler, S.

AU - Sopeña, Bernardo

AU - Suarez, Jose I.

AU - Suriñach, J. M.

AU - Tiberio, G.

AU - Tolosa, C.

AU - Trujillo-Santos, J.

AU - Uresandi, F.

AU - Valle, R.

AU - Vela, J.

AU - Villalta, J.

AU - Malfante, P. C.

AU - Verhamme, P.

AU - Wells, P.

AU - Hirmerova, J.

AU - Malý, R.

AU - Tomko, T.

AU - Salgado, E.

AU - Bertoletti, L.

AU - Bura-Riviere, A.

AU - Farge-Bancel, Dominique

AU - Hij, A.

AU - Mahé, I.

AU - Merah, A.

AU - Papadakis, M.

AU - Braester, A.

AU - Brenner, B.

AU - Tzoran, I.

AU - Apollonio, A.

AU - Barillari, G.

AU - Candeloro, Giampiero

AU - Ciammaichella, M.

AU - Di Micco, P.

AU - Ferrazzi, P.

AU - Grandone, Elvira

AU - Lessiani, Gianfranco

AU - Lodigiani, C.

AU - Mastroiacovo, D.

AU - Pace, F.

AU - Pinelli, M.

AU - Prandoni, P.

AU - Rota, L.

AU - Tiraferri, E.

AU - Tufano, A.

AU - Visonà, A.

AU - Belovs, A.

AU - Skride, A.

AU - Moreira, M.

AU - Ribeiro, J. L.

AU - Sousa, M. S.

AU - Bosevski, M.

AU - Zdraveska, M.

AU - Alatri, A.

AU - Bounameaux, H.

AU - Calanca, L.

AU - Mazzolai, L.

AU - Serrano, J. C.

AU - Decousus, Hervé

AU - Reis, Abilio

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Background We hypothesized that the clinical course of venous thromboembolism in patients with active cancer may differ according to the specificities of primary tumor site. Aim and Methods We used data from RIETE (international registry of patients with venous thromboembolism) to compare the clinical venous thromboembolism-related outcomes during the course of anticoagulation in patients with one of the 4 more frequent cancers (breast, prostate, colorectal, or lung cancer). Results As of September 2014, 3947 cancer patients were recruited, of whom 938 had breast, 629 prostate, 1189 colorectal, and 1191 lung cancer. Overall, 55% had metastatic disease (42%, 36%, 53%, and 72%, respectively). During the course of anticoagulant therapy (mean duration, 139 days), the rate of thromboembolic recurrences was similar to the rate of major bleeding in patients with breast (5.6 [95% confidence interval (CI), 3.8-8.1] vs 4.1 [95% CI, 2.7-5.9] events per 100 patient-years) or colorectal cancer (10 [95% CI, 7.6-13] vs 12 [95% CI, 9.4-15] per 100 patient-years). In contrast, in patients with prostate cancer, the rate of venous thromboembolic recurrences was half the rate of major bleeding (6.9 [95% CI, 4.4-10] vs 13 [95% CI, 9.2-17] events per 100 patient-years), whereas in those with lung cancer, the rate of thromboembolic recurrences was twofold higher than the rate of major bleeding (27 [95% CI, 22-23] vs 11 [95% CI, 8.6-15] per 100 patient-years). Conclusions Significant differences in the clinical profile of venous thromboembolic-related outcomes were observed according to the site of cancer. These findings suggest the development of cancer-specific anticoagulant strategies as an area for further research.

AB - Background We hypothesized that the clinical course of venous thromboembolism in patients with active cancer may differ according to the specificities of primary tumor site. Aim and Methods We used data from RIETE (international registry of patients with venous thromboembolism) to compare the clinical venous thromboembolism-related outcomes during the course of anticoagulation in patients with one of the 4 more frequent cancers (breast, prostate, colorectal, or lung cancer). Results As of September 2014, 3947 cancer patients were recruited, of whom 938 had breast, 629 prostate, 1189 colorectal, and 1191 lung cancer. Overall, 55% had metastatic disease (42%, 36%, 53%, and 72%, respectively). During the course of anticoagulant therapy (mean duration, 139 days), the rate of thromboembolic recurrences was similar to the rate of major bleeding in patients with breast (5.6 [95% confidence interval (CI), 3.8-8.1] vs 4.1 [95% CI, 2.7-5.9] events per 100 patient-years) or colorectal cancer (10 [95% CI, 7.6-13] vs 12 [95% CI, 9.4-15] per 100 patient-years). In contrast, in patients with prostate cancer, the rate of venous thromboembolic recurrences was half the rate of major bleeding (6.9 [95% CI, 4.4-10] vs 13 [95% CI, 9.2-17] events per 100 patient-years), whereas in those with lung cancer, the rate of thromboembolic recurrences was twofold higher than the rate of major bleeding (27 [95% CI, 22-23] vs 11 [95% CI, 8.6-15] per 100 patient-years). Conclusions Significant differences in the clinical profile of venous thromboembolic-related outcomes were observed according to the site of cancer. These findings suggest the development of cancer-specific anticoagulant strategies as an area for further research.

KW - Anticoagulant therapy

KW - Bleeding

KW - Cancer

KW - Mortality

KW - Recurrences

KW - Venous thromboembolism

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U2 - 10.1016/j.amjmed.2016.10.017

DO - 10.1016/j.amjmed.2016.10.017

M3 - Article

VL - 130

SP - 337

EP - 347

JO - American Journal of Medicine

JF - American Journal of Medicine

SN - 0002-9343

IS - 3

ER -