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实体瘤患者新开始癌症治疗后静脉血栓栓塞、出血和死亡的一年发生率:癌症-VTE注册研究结果

One-year incidence of venous thromboembolism, bleeding, and death in patients with solid tumors newly initiating cancer treatment: Results from the Cancer-VTE Registry.

作者信息

Ohashi Yasuo, Ikeda Masataka, Kunitoh Hideo, Sasako Mitsuru, Okusaka Takuji, Mukai Hirofumi, Fujiwara Keiichi, Nakamura Mashio, Oba Mari S, Kimura Tetsuya, Ibusuki Kei, Takita Atsushi, Sakon Masato

机构信息

Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan.

Division of Lower Gastrointestinal Surgery, Department of Gastroenterological Surgery, Hyogo College of Medicine, Nishinomiya, Japan.

出版信息

Thromb Res. 2022 May;213:203-213. doi: 10.1016/j.thromres.2021.09.012. Epub 2021 Sep 21.

Abstract

INTRODUCTION

Although many publications have reported the incidence of venous thromboembolism (VTE) in patients with cancer from Western countries, to date, no prospective East Asian studies have been published, and potential racial differences remain unclear. The multicenter, prospective, observational Cancer-VTE Registry aimed to clarify the incidence of VTE and bleeding and identify risk factors in Japanese patients with solid tumors after one year of follow-up.

MATERIALS AND METHODS

Patients with colorectal, lung, stomach, pancreatic, breast, or gynecologic cancer were enrolled after VTE screening and before starting cancer treatment. The follow-up period was one year. The main outcomes were the incidences of symptomatic VTE, bleeding events (major or clinically relevant non-major), and all-cause death, evaluated according to VTE presence/absence at baseline. Multivariate analyses were conducted to identify risk factors for events.

RESULTS

Among 9630 patients, the one-year cumulative incidences of symptomatic VTE, bleeding events, and all-cause death were 0.5%, 1.4%, and 12.2%, respectively. The majority of VTEs identified at baseline were asymptomatic distal deep vein thromboses; however, affected patients had higher event rates during the follow-up period. The most important independent risk factor for developing symptomatic VTE, bleeding events, and death during the follow-up period was the presence of symptomatic or asymptomatic VTE at baseline.

CONCLUSIONS

These data have revealed the incidence of symptomatic VTE in Japanese patients with solid tumors during one year of follow-up. The presence of any VTE before initiating cancer treatment was an independent risk factor for symptomatic VTE, bleeding events, and death during subsequent treatment.

摘要

引言

尽管许多出版物报道了西方国家癌症患者静脉血栓栓塞(VTE)的发生率,但迄今为止,尚未发表过前瞻性的东亚研究,潜在的种族差异仍不明确。多中心、前瞻性、观察性癌症-VTE登记旨在明确VTE和出血的发生率,并确定日本实体瘤患者随访一年后的危险因素。

材料与方法

结直肠癌、肺癌、胃癌、胰腺癌、乳腺癌或妇科癌症患者在VTE筛查后且在开始癌症治疗前入组。随访期为一年。主要结局为有症状VTE、出血事件(大出血或临床相关非大出血)和全因死亡的发生率,根据基线时是否存在VTE进行评估。进行多变量分析以确定事件的危险因素。

结果

在9630例患者中,有症状VTE、出血事件和全因死亡的一年累积发生率分别为0.5%、1.4%和12.2%。基线时发现的大多数VTE为无症状的远端深静脉血栓形成;然而,受影响的患者在随访期间事件发生率更高。随访期间发生有症状VTE、出血事件和死亡的最重要独立危险因素是基线时存在有症状或无症状VTE。

结论

这些数据揭示了日本实体瘤患者随访一年期间有症状VTE的发生率。在开始癌症治疗前存在任何VTE是后续治疗期间有症状VTE、出血事件和死亡的独立危险因素。

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