Trujillo-Santos Javier, Ruiz-Gamietea Angeles, Luque Juan Manuel, Samperiz Angel Luis, Garcia-Bragado Ferrán, Todoli José Antonio, Monreal Manuel
Department of Internal Medicine, Hospital Universitario Santa María de Rosell, Cartagena, Murcia.
Thromb Res. 2009;123 Suppl 2:S10-5. doi: 10.1016/S0049-3848(09)70003-9.
Cancer patients with venous thromboembolism (VTE) have an increased incidence of recurrences and bleeding complications Reliable information on the factors determining the risk for such complications may facilitate better use of therapy.
RIETE Registry is an ongoing, international registry of consecutive patients presenting with symptomatic acute VTE confirmed by objective tests. We assessed the 3-month outcome in all women with active cancer, trying to identify if differences exist according to the tumor site.
Up to May 2007, 18,883 patients had been enrolled. Of them, 3805 (20%) had active cancer, 1719 (45%) were women. During the 3-month study period, 40 (2.3%) had recurrent deep vein thrombosis, 39 (2.3%) recurrent pulmonary embolism (PE), 67 (3.9%) major bleeding, 394 (23%) died. Of these, 13 (33%) women with recurrent PE died of the PE, 17 (42%) with major bleeding had fatal bleeding. In women with gastrointestinal (5.7% vs. 4.3%) or genitourinary (6.4% vs. 4.7%) cancers the incidence of bleeding complications exceeded that of VTE recurrences, while in those with brain (3.4% vs. 13%) or lung cancer (2.6% vs. 11%) the rate of recurrences outweighed that of major bleeding.
We identified significant differences in outcome according to the site of cancer that may help to identify those women with cancer and VTE at a higher risk for recurrences or major bleeding.
患有静脉血栓栓塞症（VTE）的癌症患者复发率和出血并发症发生率增加。有关决定此类并发症风险因素的可靠信息可能有助于更好地进行治疗。
RIETE注册研究是一项正在进行的国际性注册研究，纳入经客观检查确诊的有症状急性VTE连续患者。我们评估了所有患有活动性癌症的女性患者3个月的结局，试图确定是否根据肿瘤部位存在差异。
截至2007年5月，已招募18883例患者。其中，3805例（20%）患有活动性癌症，1719例（45%）为女性。在3个月的研究期间，40例（2.3%）发生复发性深静脉血栓形成，39例（2.3%）复发性肺栓塞（PE），67例（3.9%）发生大出血，394例（23%）死亡。其中，13例（33%）复发性PE女性死于PE，17例（42%）大出血女性发生致命性出血。患有胃肠道（5.7%对4.3%）或泌尿生殖系统（6.4%对4.7%）癌症的女性出血并发症发生率超过VTE复发率，而患有脑癌（3.4%对13%）或肺癌（2.6%对11%）的女性复发率高于大出血率。
我们发现根据癌症部位结局存在显著差异，这可能有助于识别那些患有癌症和VTE且复发或大出血风险较高的女性。
