| PurposesTo explore the clinical characteristics. treatment and occurrences of venous thromboembolism (VTE) in patients with cancer, improve the recognition and awareness of prevention and treatment of cancer-associated thrombosis, improve the quality of life of cancer patients and prolong survival.MethodsClinical data about 376 cancer patients with VTE from August 2008 to November 2014 in PLA general hospital were retrospectively analyzed. General condition of patients (gender, age, BM1, KPS, comorbidities, etc), cancer-related condition (tumor types, the exact dates of cancer diagnosis, pathological types, differentiation, TNM, treatment for cnacer, etc), thrombosis-related condition (the exact dates of initial VTE, sites, symptom, outcome, etc) were recoded. The clinical characteristics, treatment and occurences were evaluated.ResultsOf all 376 patients, there were 185 males and 191 females with average age of (58.7 ±12.8) years (ranging from 23 to 93 years). Of these,331 cancer patients initially presented with DVT only,25 with PE only,20 with PE (with concomitant DVT). Lung cancer was the most common cancer with a thrombotic event (37.2%,140/376), followed by 99 (26.3%) digestive system neoplasms,68 (18.1%) female genital tract neoplasms,18 (4.8%) urinary system tumors,15 (4.0%) breast cancers,7 (1.9%) malignant brain tumors,6 (1.6%) head and neck neoplasms,4(1.1%) male reproductive system tumors,3 (0.8%) malignant mesotheliomas,2 (0.5%) adrenal carcinomas and 14 (3.7%) other tumors. Adenocacinoma (61.7%, n=232) was the most common pathological type. Most patients (75.5%, n=284) were in TNM stage Ⅲ-Ⅳ. Of 228 (60.6%) patients with histodifferentiation results,97.1%(67/69) were moderately and/or low differentiated. Swelling or pain of limb was the most common symptom inDVT patients, especially in lower limb DVT patients, while most PE patients had the symptom of dyspnea. Two hundred and ninety-five (78.5%) patients received anticoagulant therapy with Iow-molecular-weight heparin (LMWH) and warfarin. Two hundred and eighty-five (75.8%) patients improved when they were discharged. Only 13 (3.5%) patients received anticoagulant therapy for thromboprophylaxis. Thrombosis was diagnosed after cancer diagnosis in 307 (81.6%) patients. After a definite diagnosis of cancer,44.3%,59.3%,68.1%,73.0%and 77.5% of patients experienced a thrombotic event within 1,3,6,9 and 12 months respectively. Sixty-nine (18.4%) patients were diagnosed with cancer after thrombosis diagnosis. Of these, fifty-seven (82.6%) patients were diagnosed with cancer within the first 6 months following their thrombotic events. After cancer surgery, the incidences were 45.3%,56.0%,63.5%,68.6% and 73.0% within 1,3,6,9 and 12 months, after chemotherapy, they were 28.9%,45.2%,54.8%, 61.5% and 68.9%, respectively, and 12.9%,27.4%,45.2%,54.8% and 61.3%, respectively after radiotherapy. Conclusions1. Of all cancers with VTE, lung cancer is most common, followed by digestive system neoplasms, female genital tract neoplasms, urinary system tumors, breast cancers, etc.2. Adenocacinoma is the major pathological type and most patients are diagnosed at late stage.3. Most patients have received anticoagulation therapy and the prognosis is good.4. VTE may be the first signal of cancer, the greatest period of detection is within the first 6 months following their thrombotic events.5. The risk of VTE is highest within the first 6 months after cancer diagnosis, surgery, chemotherapy, radiotherapy.6. Cancers patients with VTE risk factors can use anticoagulant for thromboprophylaxis in the absence of contraindications. |
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