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Risk for Venous Thromboembolic Events in Patients With Advanced Urinary Tract Cancer Treated With First-Line Chemotherapy.
- Source :
-
Clinical genitourinary cancer [Clin Genitourin Cancer] 2020 Aug; Vol. 18 (4), pp. e457-e472. Date of Electronic Publication: 2020 Jan 08. - Publication Year :
- 2020
-
Abstract
- Background: Venous thromboembolic events (VTEs) frequently occur in cancer patients. Risk assessment models (RAMs) for cancer-associated thrombosis have been proposed. However, advanced urinary tract cancer (aUTC) was not adequately represented in these models. We studied the incidence of VTEs, the risk factors, and the applicability of recently described RAMs.<br />Patients and Methods: Data from 335 patients with aUTC treated with chemotherapy between April 1995 and September 2015 in a single institution were analyzed.<br />Results: A total of 95.2% received platinum-based first-line chemotherapy. Twenty-nine patients (8.7%) experienced VTEs. The 6-, 12-, and 24-month VTE incidence was 7.4% (95% confidence interval [CI], 4.8-10.6), 8.1% (95% CI, 5.4-11.5) and 9.4% (95% CI, 6.4-13.1), respectively. No significant association of VTE incidence with the Khorana risk score was observed. History of vascular event (VTE and/or arterial thromboembolic event) was significantly associated with the development of VTE. Patients with such history had a 6-, 12-, and 24-month VTE incidence of 16.2% (95% CI, 6.6-29.7), 19.2% (95% CI, 8.4-33.3), and 25.2% (95% CI, 12.5-40.1) compared to 6.2% (95% CI, 3.7-9.4), 6.6% (95% CI, 4.1-10), and 7.1% (95% CI, 4.4-10.6) of those who did not. The discriminatory ability of this factor adjusted for leucocyte count, sex, Eastern Cooperative Oncology Group performance status, and type of chemotherapy reached 0.79 (95% CI, 0.71-0.87) compared to the 0.58 (95% CI, 0.49-0.66) for the Khorana risk score.<br />Conclusion: Development of tumor-specific algorithms for the risk of VTEs is advisable. Patients with aUTC and a history of vascular events are at high risk for VTE development, and prophylaxis should be prospectively studied in this group.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Anticoagulants therapeutic use
Female
Follow-Up Studies
Greece epidemiology
Humans
Incidence
Male
Middle Aged
Prognosis
Retrospective Studies
Risk Factors
Survival Rate
Urologic Neoplasms pathology
Venous Thromboembolism chemically induced
Venous Thromboembolism drug therapy
Venous Thromboembolism pathology
Antineoplastic Combined Chemotherapy Protocols adverse effects
Urologic Neoplasms drug therapy
Venous Thromboembolism epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1938-0682
- Volume :
- 18
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Clinical genitourinary cancer
- Publication Type :
- Academic Journal
- Accession number :
- 32007440
- Full Text :
- https://doi.org/10.1016/j.clgc.2019.12.021