OC-15 - Risk factors for cancer development after idiopathic venous thromboembolism

B Cosmi; C Legnani; A Ghirarduzzi; V De Micheli; V Pengo; S Testa; D Poli; E Antonucci; D Prisco; A Tripodi; P Prandoni; G Palareti; FCSA, Italian Federation of Anticoagulation Clinics

doi:10.1016/S0049-3848(16)30132-3

OC-15 - Risk factors for cancer development after idiopathic venous thromboembolism

Thromb Res. 2016 Apr:140 Suppl 1:S174. doi: 10.1016/S0049-3848(16)30132-3. Epub 2016 Apr 8.

Authors

B Cosmi¹, C Legnani¹, A Ghirarduzzi², V De Micheli³, V Pengo⁴, S Testa⁵, D Poli⁶, E Antonucci⁶, D Prisco⁶, A Tripodi⁷, P Prandoni⁸, G Palareti¹; FCSA, Italian Federation of Anticoagulation Clinics

Affiliations

¹ Dept. Angiology & Blood Coagulation, University Hospital S. Orsola-Malpighi, Bologna.
² Dept. Internal Medicine I, Angiology, Arcispedale Santa Maria Nuova, Reggio Emilia.
³ Haemostasis and Thrombosis Centre, Hospital of Lecco.
⁴ Dept. of Cardiothoracic and Vascular Sciences, University Hospital of Padua.
⁵ Haemostasis & Thrombosis Center, General Hospital, Cremona.
⁶ Thrombosis Centre, Dept. Heart and Vessels, University Hospital of Florence.
⁷ Angelo Bianchi Bonomi Hemophilia & Thrombosis Center, Dept. Internal Medicine, University & IRCCS Maggiore Hospital, Milan.
⁸ Internal Medicine, Dept. of Medical and Surgical Sciences, University Hospital of Padua; Italy.

PMID: 27161686
DOI: 10.1016/S0049-3848(16)30132-3

Abstract

Introduction: Idiopathic venous thromboembolism (VTE) is associated with the risk of cancer but the risk factors for cancer development in such patients are still uncertain.

Aim: To assess risk factors for the development of cancer after a standard course of anticoagulation in patients with first episode of idiopathic VTE.

Materials and methods: Subjects were enrolled in the three large prospective multicentre studies: PROLONG (NEJM 2006) PROLONG II (Blood 2010) and DULCIS (Blood 2014). Women whose index event was hormone related were excluded from the analysis. The development of cancer was recorded during a 2-year follow-up.

Results: 1,805 patients were enrolled (M/F: 510/453), mean age: 62, median: 67; range:18-87 years). Cancer developed in 55 patients (3% ; 1.7% pt-years) of whom 15 (2.0%; 1.1% pt-years) had PE with or without DVT and 40 (3.8%; 2.1% pt-years) had DVT without PE (p=0.03). The development of cancer was associated with DVT without PE (HR:1.8; 95% CI: 1.1-3.3) and age >65 (HR: 2.5; 95%: 1.3-4.9). Among patients with DVT, with or without PE, the development of cancer was associated with the presence of residual vein obstruction>4mm (RVO) at compression ultrasound (HR: 1.8, 95% CI: 1.1-3.3) and age>65 (HR: 2.8; 95% CI: 1.3-6.2).

Conclusions: Age>65 years, DVT without PE and the presence of RVO are significantly associated with the risk of developing cancer after a first episode of idiopathic VTE over a two-year follow-up.