Department of Internal Medicine, Hospital Virgen del Puerto. Paraje Valcorchero S/N, 10600 Plasencia, Spain.
Department of Medical Sciences, Faculty of Health Sciences, Castilla-La Mancha University. Avenida Real Fábrica de Sedas S/N, 45600 Talavera de la Reina, Spain.
Thromb Res. 2023 Nov;231:84-90. doi: 10.1016/j.thromres.2023.10.002. Epub 2023 Oct 9.
The incidence of splanchnic vein thrombosis (SVT) in cancer patients has increased in recent years and its real clinical significance and management can be challenging. This study aimed to describe the clinical presentation and short-term outcomes of patients with cancer-associated SVT.
This was a retrospective observational study of consecutive patients with cancer-associated SVT diagnosed during the period 2015-2020. The primary objective was to describe the clinical presentation of SVT. Patients were clinically classified into two groups based on the presence of symptoms on SVT diagnosis. The main outcomes were overall and SVT-related mortality, major and non-major bleeding rates, and the thrombosis recurrence rate in the first 30 days of follow-up.
This study enrolled 203 patients. Intra-abdominal tumors (76 %) and metastatic disease (68 %) predominated. A total of 79 (39 %) patients without symptoms were diagnosed with SVT during a scheduled radiological test and were classified as "asymptomatic", while 124 (61 %) patients presented some potential SVT symptoms and were considered as "symptomatic". Although the 30-day outcomes showed no significant differences between the two groups, mortality in the asymptomatic group was slightly lower compared to the symptomatic group (3 % vs. 10 %, p = 0.085).
Almost 40 % of cases of cancer-associated SVT are asymptomatic. There were no significant differences in short-term outcomes between the symptomatic and asymptomatic patients. More studies are required to better define long-term management and outcomes in these patients.
近年来,癌症患者的内脏静脉血栓形成(SVT)发病率有所增加,其真实的临床意义和处理方法具有挑战性。本研究旨在描述与癌症相关的 SVT 患者的临床表现和短期结局。
这是一项回顾性观察研究,连续纳入了 2015 年至 2020 年期间诊断出的与癌症相关的 SVT 患者。主要目的是描述 SVT 的临床表现。根据 SVT 诊断时是否存在症状,将患者临床分为两组。主要结局为总死亡率和 SVT 相关死亡率、大出血和非大出血发生率以及随访第 30 天内血栓复发率。
本研究纳入了 203 例患者。其中,腹腔内肿瘤(76%)和转移性疾病(68%)占主导地位。共有 79 例(39%)无症状的患者在计划进行的影像学检查中诊断出 SVT,被归类为“无症状”,而 124 例(61%)患者出现了一些潜在的 SVT 症状,被认为是“有症状”。尽管两组患者在 30 天结局上没有显著差异,但无症状组的死亡率略低于有症状组(3%比 10%,p=0.085)。
近 40%的癌症相关 SVT 病例为无症状。有症状和无症状患者的短期结局无显著差异。需要进一步研究以更好地确定这些患者的长期管理和结局。