Mahé Isabelle, Plaisance Ludovic, Chapelle Céline, Laporte Silvy, Planquette Benjamin, Bertoletti Laurent, Couturaud Francis, Falvo Nicolas, Falchero Lionel, Mahé Isild, Helfer Hélène, Chidiac Jean, Meyer Guy
Hôpital Louis Mourier, Assistance Publique des Hôpitaux de Paris, Université de Paris, 92700 Colombes, France.
F-CRIN INNOVTE network, F-42055 Saint-Etienne, France.
Cancers (Basel). 2020 Aug 12;12(8):2256. doi: 10.3390/cancers12082256.
extended anticoagulant therapy beyond the initial 6 months is suggested in patients with cancer-associated thrombosis (CAT) and active cancer. Few data are available on patient management and outcomes on the period between 6 and 12 months after the venous thromboembolism (VTE) event.
our objective was to document patient management and outcomes beyond 6 months and up to 12 months in CAT patients initially treated for 6 months with tinzaparin.
adult CAT patients with a cancer still alive at the end of an initial 6-month treatment period were eligible to participate in this retrospective non-interventional French multicenter study.
a total of 432 patients aged 66.5 ± 12.7 years were available to participate in this study. Out of the patients included in the study, the anticoagulant treatment was maintained in 348 of 422 documented patients (82.5%) while it was discontinued in 74 (17.5%) patients (before the end or at the end of the initial 6-month treatment period). Between 6 and 12 months, 24 patients (5.7%) experienced VTE recurrence, while 21 (5.1%) patients had clinically relevant bleeding, 11 patients (2.7%) had major bleeding and 96 patients (22.3%) died, mostly from cancer. VTE recurrence was more frequent in patients with lung (14.3%) and colorectal cancer (6.0%) while major bleeding was more frequent in patients with colorectal cancer (6.0%).
clinical outcomes were consistent with previous observations and variable according to the type of cancer. Further clinical research is required to orient the management of patients with CAT beyond 6 months based on cancer-specific treatment strategies.
对于癌症相关血栓形成（CAT）和活动性癌症患者，建议在最初6个月后进行延长抗凝治疗。关于静脉血栓栓塞（VTE）事件后6至12个月期间的患者管理和结局的数据很少。
我们的目的是记录最初接受6个月替扎肝素治疗的CAT患者6个月以上至12个月的患者管理和结局。
在最初6个月治疗期结束时癌症仍存活的成年CAT患者有资格参加这项回顾性非干预性法国多中心研究。
共有432名年龄为66.5±12.7岁的患者可参与本研究。在纳入研究的患者中，422名有记录的患者中有348名（82.5%）维持抗凝治疗，而74名（17.5%）患者停用抗凝治疗（在最初6个月治疗期结束前或结束时）。在6至12个月期间，24名患者（5.7%）发生VTE复发，21名（5.1%）患者发生临床相关出血，11名患者（2.7%）发生大出血，96名患者（22.3%）死亡，主要死于癌症。肺癌患者（14.3%）和结直肠癌患者（6.0%）的VTE复发更频繁，而结直肠癌患者（6.0%）的大出血更频繁。
临床结局与先前观察结果一致，且因癌症类型而异。需要进一步的临床研究，以根据癌症特异性治疗策略指导6个月以上CAT患者的管理。
