Centre for Public Health, Queen's University Belfast, Northern Ireland, United Kingdom.
Leuk Lymphoma. 2011 May;52(5):764-70. doi: 10.3109/10428194.2010.551572. Epub 2011 Jan 27.
Survival is reportedly worse in patients with cancer concurrently diagnosed with deep venous thrombosis. However, information on specific malignancies is limited. From a cohort study of male US veterans we identified incident cancer cases (n = 412,008) and compared survival patterns among those with versus without a history of deep venous thrombosis. Using Cox proportional hazard models, we estimated hazard ratios (HRs) and 95% confidence intervals as measures of the relative risk of dying. Individuals with (versus without) a concomitant deep venous thrombosis and cancer diagnosis had a higher risk of dying (HR = 1.38; 1.28-1.49). The most prominent excess mortality (HR = 1.29-2.55) was observed among patients diagnosed with deep venous thrombosis at the time of diagnosis of lung, gastric, prostate, bladder, or kidney cancer. Increased risk of dying was also found among cancer patients diagnosed with deep venous thrombosis 1 year (HR = 1.14; 1.07-1.22), 1-5 years (HR = 1.14; 1.10-1.19), and >5 years (HR = 1.27; 1.23-1.31) before cancer; this was true for most cancer sites (HR = 1.17-1.64). In summary, antecedent deep venous thrombosis confers a worse prognosis upon cancer patients. Advanced stage at diagnosis, treatment effects, lifestyle factors, and comorbidity could explain differences by cancer site and time frame between a prior deep venous thrombosis diagnosis and cancer outcome.
据报道，同时患有癌症和深静脉血栓的患者的生存率更差。然而，关于特定恶性肿瘤的信息有限。我们从一项针对美国男性退伍军人的队列研究中确定了新发癌症病例（n=412,008），并比较了有和无深静脉血栓病史的患者的生存模式。使用 Cox 比例风险模型，我们估计了风险比（HR）和 95%置信区间，作为死亡相对风险的衡量指标。同时患有（与不患有）深静脉血栓和癌症诊断的个体死亡风险更高（HR=1.38；1.28-1.49）。在诊断为肺癌、胃癌、前列腺癌、膀胱癌或肾癌时同时诊断出深静脉血栓的患者，其死亡率明显升高（HR=1.29-2.55）。在癌症患者被诊断出深静脉血栓后 1 年（HR=1.14；1.07-1.22）、1-5 年（HR=1.14；1.10-1.19）和>5 年（HR=1.27；1.23-1.31）时，也发现了死亡风险增加，这在大多数癌症部位都是如此（HR=1.17-1.64）。总之，深静脉血栓的前期存在会对癌症患者的预后产生不利影响。诊断时的晚期阶段、治疗效果、生活方式因素和合并症可能解释了癌症部位和深静脉血栓诊断与癌症结局之间的时间框架差异。
