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多原发恶性肿瘤患者静脉血栓栓塞性疾病的负担和预测因素。

The burden and predictors of venous thromboembolic diseases in patients with multiple primary malignancies.

机构信息

College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia.

King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia.

出版信息

Cancer Rep (Hoboken). 2023 Mar;6(3):e1742. doi: 10.1002/cnr2.1742. Epub 2022 Oct 31.

Abstract

BACKGROUND

Venous thromboembolism (VTE) represents a considerable burden on cancer patients' survival and quality of life, but this burden varies based on the patient's baseline characteristics and cancer-related factors. Although solid evidence on the predictors and effect of VTE in cancer patients exists.

AIM

To evaluate VTE rate, morbidity, and mortality to develop parameters that could predict VTEs and their associated mortality in patients with multiple primary malignancies (MPMs).

METHOD AND RESULTS

This was a retrospective cohort study that took place at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. Two hundred and forty-two patients with at least two biopsy-proven malignancies and had at least 3 months of follow-up after MPMs diagnosis were included. VTE was diagnosed in 14.5% of the cases, two-thirds of which were deep vein thrombosis. VTE was significantly associated with a higher mortality and worse survival. Predictors of VTE after MPMs diagnosis were a high ECOG performance status at MPMs diagnosis, a metastatic first primary malignancy, and ICU admission after MPMs diagnosis. Having a GI or hematological malignancy as the second primary malignancy, a high D-dimer at ICU admission, and palliative care referral were significantly associated with a higher mortality in patients who had VTE.

CONCLUSION

VTE was diagnosed in 14.5% of patients with MPMs and it significantly compromises their survival. We believe that these results might be of particular benefit since the phenomenon of MPMs is becoming more frequently encountered.

摘要

背景

静脉血栓栓塞症(VTE)对癌症患者的生存和生活质量造成了相当大的负担,但这种负担因患者的基线特征和癌症相关因素而异。尽管已经有关于癌症患者 VTE 预测因素和影响的充分证据。

目的

评估 VTE 的发生率、发病率和死亡率,以确定可预测 VTE 及其相关死亡率的参数,这些参数适用于患有多种原发性恶性肿瘤(MPMs)的患者。

方法和结果

这是一项回顾性队列研究,在沙特阿拉伯利雅得的阿卜杜勒阿齐兹国王医疗城进行。纳入了 242 名至少有两种经活检证实的恶性肿瘤且在 MPMs 诊断后至少有 3 个月随访的患者。14.5%的病例诊断为 VTE,其中三分之二为深静脉血栓形成。VTE 与更高的死亡率和更差的生存显著相关。MPMs 诊断后 VTE 的预测因素包括 MPMs 诊断时较高的 ECOG 表现状态、转移性首发恶性肿瘤和 MPMs 诊断后的 ICU 入院。第二原发恶性肿瘤为胃肠道或血液恶性肿瘤、ICU 入院时 D-二聚体水平较高以及姑息治疗转诊与 VTE 患者的高死亡率显著相关。

结论

14.5%的 MPMs 患者诊断为 VTE,这显著影响了他们的生存。我们相信,这些结果可能特别有益,因为 MPMs 的现象越来越普遍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2afc/10026306/300e68cf6d67/CNR2-6-e1742-g004.jpg

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