Department of Internal Medicine, Division of Hematology/Oncology, University of California Davis, Sacramento, California, USA.
Cancer. 2010 Jun 1;116(11):2596-603. doi: 10.1002/cncr.25004.
The incidence, risk factors, time course, and impact on survival of venous thromboembolism (VTE) in a large, population-based study of patients with bladder cancer have not been identified previously.
The California Cancer Registry was merged with the California Patient Discharge Data Set to determine the incidence of VTE in patients with newly diagnosed bladder cancer within a 6-year period. Cox proportional hazards models were used to determine the risk factors for VTE and the effects of VTE on survival.
Among 24,861 patients with bladder cancer, the 2-year incidence of VTE was 1.9%. The highest incidence of VTE occurred in the first 6 months regardless of age, sex, race, tumor stage, or histologic subtype. In a multivariate model, significant risk factors for the development of VTE included major surgery, advancing disease stage, and increasing number of comorbidities. Compared with the general population, the 1-year standardized incidence ratio for VTE in the bladder cancer cohort was 5.3 (95% confidence interval, 4.8-5.9). Among patients with bladder cancer, significant risk factors for death included advancing disease stage, increasing comorbidities, African-American race, nontransitional cell carcinoma histology, and the development of VTE.
Patients with bladder cancer had a 1.9% 2-year incidence of VTE. Metastatic disease was the strongest predictor of both VTE and death. It was noteworthy that cancer-associated surgery was associated with a higher risk of VTE, which differed from the results reported from other studies in solid tumors. VTE was a significant predictor of death in the first 2 years.
此前尚未在一项大型基于人群的膀胱癌患者研究中确定静脉血栓栓塞症（VTE）的发病率、危险因素、时间进程及其对生存的影响。
将加利福尼亚癌症登记处与加利福尼亚患者出院数据集合并，以确定在 6 年内新诊断为膀胱癌的患者中 VTE 的发病率。使用 Cox 比例风险模型来确定 VTE 的危险因素以及 VTE 对生存的影响。
在 24861 例膀胱癌患者中，VTE 的 2 年发病率为 1.9%。无论年龄、性别、种族、肿瘤分期或组织学亚型如何，VTE 的最高发病率均发生在最初的 6 个月内。在多变量模型中，VTE 发展的显著危险因素包括大手术、疾病进展和合并症数量增加。与普通人群相比，膀胱癌队列中 VTE 的 1 年标准化发病比为 5.3（95%置信区间，4.8-5.9）。在膀胱癌患者中，死亡的显著危险因素包括疾病进展、合并症增加、非裔美国人种族、非移行细胞癌组织学和 VTE 的发展。
膀胱癌患者的 2 年 VTE 发病率为 1.9%。转移性疾病是 VTE 和死亡的最强预测因素。值得注意的是，与其他实体瘤研究报告的结果不同，癌症相关手术与 VTE 的风险增加相关。VTE 是前 2 年死亡的重要预测因素。
