Debourdeau Philippe, Bertoletti Laurent, Font Carme, López-Núñez Juan José, Gómez-Cuervo Covadonga, Mahe Isabelle, Otero-Candelera Remedios, Adarraga Maria Dolores, López-Miguel Patricia, Monreal Manuel
Centre Hospitalier Joseph Imbert, BP 80195, 13637 Arles, France.
Département of Médecine Vasculaire et Thérapeutique, CIC 1408, SAINBIOSE U1059, INSERM, CHU Saint-Étienne, Mines Saint-Etienne, Université Jean Monnet Saint-Étienne, 42000 Saint-Etienne, France.
Cancers (Basel). 2023 Mar 29;15(7):2034. doi: 10.3390/cancers15072034.
The clinical characteristics and outcomes of cancer patients with lower-limb isolated superficial vein thrombosis (SVT) have not been consistently evaluated.
We used data in the RIETE registry to compare the clinical characteristics and 90-day outcomes for patients with: (1) active cancer and lower-limb SVT; (2) active cancer and lower-limb deep vein thrombosis (DVT); (3) lower-limb SVT without cancer. The primary outcomes included subsequent symptomatic SVT, DVT or pulmonary embolism (PE). Secondary outcomes were major bleeding and death.
From March 2015 to April 2021, there were 110 patients with cancer and SVT, 1695 with cancer and DVT, and 1030 with SVT but no cancer. Most patients in all subgroups (93%, 99% and 96%, respectively) received anticoagulants, while those with SVT received lower daily doses of low-molecular-weight heparin (114 ± 58, 163 ± 44, and 106 ± 50 IU/kg, respectively). During the first 90 days, 101 patients (3.6%) developed subsequent VTE (PE 47, DVT 41, SVT 13), whereas 72 (2.5%) had major bleeding and 282 (9.9%) died. Among the three groups, 90-day events were, respectively: VTE at rates of 7.3%, 4.0% and 2.4%; major bleeding at rates of 2.7%, 3.9% and 0.3%; mortality at rates of 8.2%, 16% and 0.3%. Between D90 and D180, only one SVT recurrence and one death occurred in SVT cancer patients. In multivariable analysis, cancer was associated with subsequent VTE (HR = 2.04; 1.15-3.62), while initial presentation as SVT or DVT were not associated with a different risk.
The risk for subsequent VTE (including symptomatic SVT, DVT or PE) was similar in cancer patients with isolated SVT than in those with isolated DVT.
下肢孤立性浅静脉血栓形成（SVT）癌症患者的临床特征和预后尚未得到一致评估。
我们利用RIETE注册中心的数据，比较以下患者的临床特征和90天预后：（1）活动性癌症合并下肢SVT；（2）活动性癌症合并下肢深静脉血栓形成（DVT）；（3）无癌症的下肢SVT。主要结局包括随后出现的症状性SVT、DVT或肺栓塞（PE）。次要结局为大出血和死亡。
2015年3月至2021年4月，有110例癌症合并SVT患者、1695例癌症合并DVT患者和1030例SVT但无癌症患者。所有亚组中的大多数患者（分别为93%、99%和96%）接受了抗凝治疗，而SVT患者接受的低分子量肝素每日剂量较低（分别为114±58、163±44和106±50 IU/kg）。在最初的90天内，101例患者（3.6%）出现了随后的静脉血栓栓塞（47例PE、41例DVT、13例SVT），而72例（2.5%）发生了大出血，282例（9.9%）死亡。在三组中，90天事件分别为：静脉血栓栓塞发生率分别为7.3%、4.0%和2.4%；大出血发生率分别为2.7%、3.9%和0.3%；死亡率分别为8.2%、16%和0.3%。在D90和D180之间，SVT癌症患者仅发生1例SVT复发和1例死亡。在多变量分析中，癌症与随后的静脉血栓栓塞相关（HR = 2.04；1.15 - 3.62），而最初表现为SVT或DVT与不同风险无关。
孤立性SVT癌症患者随后发生静脉血栓栓塞（包括症状性SVT、DVT或PE）的风险与孤立性DVT癌症患者相似。
