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在诊断出指数型静脉血栓栓塞症(VTE)后,接受抗凝治疗的晚期实体瘤患者中,复发性静脉血栓栓塞症(VTE)的发生率、风险因素和预后。

The incidence, risk factors, and prognosis of recurrent venous thromboembolism (VTE) in patients with advanced solid cancers receiving anticoagulation therapy after the diagnosis of index VTE.

机构信息

Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea.

出版信息

Thromb Res. 2013 Apr;131(4):e133-40. doi: 10.1016/j.thromres.2013.01.025. Epub 2013 Feb 9.

Abstract

UNLABELLED

Patients with cancer have been associated with increased risk of recurrent venous thromboembolism (VTE). However, data on recurrent VTE in Asian patients with advanced solid cancers are limited.

METHODS

This study was conducted using data from the Korean VTE registry, which is an ongoing, prospective database. Patients were eligible if they had diagnosed with recurrent/metastatic solid cancers and initiated anticoagulation therapy following index VTE diagnosis. A total of 449 patients were included in this analysis. The 6-month and 12-month cumulative incidences of recurrent VTE were 20.6% and 27.0%, respectively. Isolated pulmonary embolism (PE) (51%) was the most predominant recurrence type. Pancreas as the primary tumor site, poor Eastern Cooperative Oncology Group performance status at the time of index VTE diagnosis, and initial presentation with PE were independent risk factors for developing recurrent VTE. With a median follow-up of 29.1months (range, 1.0-91.2), the median overall survival (OS) was 11.9months. Patients with recurrent VTE had a significantly worse OS than those without recurrent VTE (median, 8.4 vs. 13.0months, respectively; P=0.001). In conclusion, the incidence of recurrent VTE in Korean patients with advanced solid cancers is comparable with Caucasian patients. Pancreas as the primary tumor site, poor performance status, and initial presentation with PE are independent recurrent VTE risk factors in advanced cancer VTE patients. Additionally, OS is adversely affected by recurrent VTE.

摘要

未标注

癌症患者与复发性静脉血栓栓塞症(VTE)的风险增加相关。然而,亚洲晚期实体瘤患者复发性 VTE 的数据有限。

方法

本研究使用了韩国 VTE 登记处的数据,该登记处是一个正在进行的前瞻性数据库。如果患者被诊断患有复发性/转移性实体瘤,并在首次 VTE 诊断后开始抗凝治疗,则符合入组条件。本分析共纳入 449 例患者。复发性 VTE 的 6 个月和 12 个月累积发生率分别为 20.6%和 27.0%。孤立性肺栓塞(PE)(51%)是最主要的复发类型。原发肿瘤位于胰腺、首次 VTE 诊断时东部合作肿瘤学组(ECOG)表现状态较差以及初始表现为 PE 是发生复发性 VTE 的独立危险因素。中位随访时间为 29.1 个月(范围,1.0-91.2),中位总生存期(OS)为 11.9 个月。与无复发性 VTE 的患者相比,发生复发性 VTE 的患者的 OS 明显更差(中位 OS 分别为 8.4 个月和 13.0 个月,P=0.001)。总之,韩国晚期实体瘤患者的复发性 VTE 发生率与高加索患者相当。原发肿瘤位于胰腺、较差的 ECOG 表现状态和初始表现为 PE 是晚期癌症 VTE 患者发生复发性 VTE 的独立危险因素。此外,复发性 VTE 会对 OS 产生不利影响。

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