Metcalf R L, Fry D J, Swindell R, McGurk A, Clamp A R, Jayson G C, Hasan J
Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK.
Br J Cancer. 2014 Mar 4;110(5):1118-24. doi: 10.1038/bjc.2014.3. Epub 2014 Jan 21.
Thrombotic events are common in cancer patients and have been associated with an adverse prognosis in large registry-based studies.
A retrospective cohort of 417 patients with ovarian cancer treated at a tertiary cancer centre between 2006 and 2009 was studied to identify the incidence and risk factors for thrombotic events and the prognostic impact of thrombosis. Patient outcomes were evaluated against a matched control group without thrombosis.
Ninety-nine thrombotic events occurred in 90 patients (21.6%) from 8 months before diagnosis to 56 months following diagnosis, peaking in the 4 months following diagnosis. Patients with thrombosis were older (mean 65 vs 61 years, P=0.007), had a worse performance status (PS ≥2: 29.9% vs 9.5%, P<0.0001) and had a more advanced FIGO stage (FIGO III/IV 75.6% vs 56.9%, P<0.0001) than patients without thrombosis. Shorter overall survival was seen in patients with pulmonary embolism and pelvic/lower limb deep vein thrombosis than without thrombosis (P=0.001). When the control group was matched for stage and PS, no survival difference was seen (P=0.91).
Ovarian cancer patients with thrombotic events had a shorter survival. However, when matched for prognostic factors (PS and FIGO stage), thrombosis did not impact upon prognosis.
血栓形成事件在癌症患者中很常见，在基于大型登记处的研究中已发现其与不良预后相关。
对2006年至2009年在一家三级癌症中心接受治疗的417例卵巢癌患者进行回顾性队列研究，以确定血栓形成事件的发生率和危险因素以及血栓形成的预后影响。将患者的结局与无血栓形成的匹配对照组进行评估。
从诊断前8个月至诊断后56个月，90例患者（21.6%）发生了99次血栓形成事件，在诊断后4个月达到高峰。与无血栓形成的患者相比，有血栓形成的患者年龄更大（平均65岁对61岁，P=0.007），体能状态更差（PS≥2：29.9%对9.5%，P<0.0001），国际妇产科联盟（FIGO）分期更晚（FIGO III/IV期：75.6%对56.9%，P<0.0001）。有肺栓塞和盆腔/下肢深静脉血栓形成的患者总生存期比无血栓形成的患者短（P=0.001）。当对照组按分期和PS进行匹配时，未观察到生存差异（P=0.91）。
发生血栓形成事件的卵巢癌患者生存期较短。然而，在按预后因素（PS和FIGO分期）进行匹配后，血栓形成并不影响预后。
