Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
Blood. 2013 Sep 5;122(10):1712-23. doi: 10.1182/blood-2013-04-460121. Epub 2013 Aug 1.
Cancer-associated venous thrombosis is a common condition, although the reported incidence varies widely between studies depending on patient population, start and duration of follow-up, and the method of detecting and reporting thrombotic events. Furthermore, as cancer is a heterogeneous disease, the risk of venous thrombosis depends on cancer types and stages, treatment measures, and patient-related factors. In general, cancer patients with venous thrombosis do not fare well and have an increased mortality compared with cancer patients without. This may be explained by the more aggressive type of malignancies associated with this condition. It is hypothesized that thromboprophylaxis in cancer patients might improve prognosis and quality of life by preventing thrombotic events. However, anticoagulant treatment leads to increased bleeding, particularly in this patient group, so in case of proven benefit of thromboprophylaxis, only patients with a high risk of venous thrombosis should be considered. This review describes the literature on incidence of and risk factors for cancer-associated venous thrombosis, with the aim to provide a basis for identification of high-risk patients and for further development and refinement of prediction models. Furthermore, knowledge on risk factors for cancer-related venous thrombosis may enhance the understanding of the pathophysiology of thrombosis in these patients.
癌症相关性静脉血栓栓塞症是一种常见病症,尽管不同研究的报告发病率差异很大,这取决于患者人群、随访开始和持续时间,以及检测和报告血栓事件的方法。此外,由于癌症是一种异质性疾病,静脉血栓形成的风险取决于癌症类型和分期、治疗措施以及患者相关因素。一般来说,患有静脉血栓栓塞症的癌症患者预后较差,死亡率高于没有该病症的癌症患者。这可能是由于与这种情况相关的恶性肿瘤更具侵袭性。据推测,癌症患者的血栓预防可能通过预防血栓事件来改善预后和生活质量。然而,抗凝治疗会导致出血增加,特别是在这类患者群体中,因此,如果血栓预防有明确的益处,只有静脉血栓栓塞高危患者才应考虑进行血栓预防。本综述描述了癌症相关性静脉血栓栓塞症的发病率和危险因素的文献,旨在为识别高危患者提供依据,并进一步开发和完善预测模型。此外,对癌症相关静脉血栓形成危险因素的了解可以增强对这些患者血栓形成病理生理学的理解。