Clinical analysis of cancer patients with venous thromboembolism
Received:May 20, 2016  Revised:June 23, 2016
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Key words:malignant tumor  venous thromboembolism  pulmonary thromboembolism  deep vein thrombosis
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PU Chun, XU Xiao-Mao*, QIAO Li-Song, YANG He, JIN Jin Department of Respiratory and Critical Care Medicine, Beijing Hospital, Beijing 100730, China 
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      Objective To identify the clinical features of cancer patients with venous thromboembolism (VTE), including types, stages and differentiation of the primary cancers, in order to identify high-risk patients, improve awareness of prevention and control, and reduce the occurrence of the disease. Methods A total of 280 cancer patients who were diagnosed with VTE in our hospital from January 2003 to January 2013 were recruited in this study. Their demographic and clinical data, including age, gender, differentiation, pathological types, TNM stages, chemotherapeutic regimens and prognosis were collected and retrospectively analyzed. Results A total of 280 cancer patients with VTE were enrolled, including 157 males and 123 females at an age of (66.60±12.60) years. There were 41 cases of isolated pulmonary thromboembolism (PTE), 189 of deep vein thrombosis (DVT) and 50 of PTE combined with DVT. Among them, 82 patients were lung cancers, 78 gastrointestinal cancer, 32 urinary tract tumor, 27 gynecological tumor, 27 haematological tumor, 12 breast cancer, and 22 other cancers. Compared with the cancer patients without VTE, VTE was more common in the patients with lung, gynecological and other cancers (P<0.05). Among all the patients, 151(53.9%) were diagnosed with adenocarcinoma, and 206 patients (73.6%) presented advanced cancer when developing VTE. For the 247 patients with explicit TNM stage, 187(66.8%) of them were at stage Ⅲ-Ⅳ. Among the 144 patients with definite cancer differentiation, 120(85.4%) were at moderate and poor differentiation. Till the end of follow-up, 130 patients died with a median survival time of (24.0±7.8) months. The cumulative mortality rates within 3, 6, 9 and 12 months were 46.9%, 69.2%, 80.0% and 82.3% respectively. The top 3 causes of death were cancer, PTE and infection. Conclusion Cancer is closely associated with VTE. Adenocarcinoma, advanced cancer, low differentiation of tumor and chemotherapeutic regimens containing platinum are more prone to developing VTE. Clinicians should pay attention to these patients, perform VTE risk evaluation, and take the necessary precautionary measures to reduce the incidence of VTE.