Venous thromboembolism in patients with renal cell carcinoma: Incidence, risk factors, and prognostic implication.

Abstract

446 Background: Renal cell ca (RCC) is one of solid tumor with relatively highest incidence of venous thromboembolism (VTE). But, there have been to no large-scale studies that focused on VTE in RCC. The aim of this study was to investigate the incidence, time course of VTE, risk factors, and prognosis associated with VTE in RCC patients in Korea. Methods: The medical records of RCC patients (n=1248) histologically diagnosed at Severance Hospital, Yonsei University College of Medicine, Seoul, Korea from Jan 2005 to Mar 2011 were retrospectively reviewed. Results: Among 1248 RCC patients, 69.6% were men, median age was 56years (range: 4∼89), and stage distribution was stage I 65.1%, stage II 9.2%, stage III 10.4%, stage IV 12.5%. The 2-year cumulative incidences of tumor induced VTE (tVTE) was detected in 78 patients (6.3%), while 1-month, 6-months and 1-year cumulative incidence of tVTE were 5.3%, 5.7% and 6.0%, retrospectively. Two-year cumulative incidence of tVTE seemed to increase with stage (0.6%, 3.5%, 22.3% and 24.3% in stages I, II, III and IV, retrospectively). Almost tVTE events developed in the first few months after diagnosis. Stage and metastatic disease were independent risk factors for developing tVTE. In multivariate analysis, the development of tVTE was a significant predictor of survival (P=0.004) and stage, age, ECOG PS was also independent predictor of survival. Conclusions: This is the first study that specially focused on tVTE in RCC. The 2-year cumulative incidence of tVTE in Korean patients with RCC was 6.3%, which is similar to other ethnic group. As tVTE related to poorer survival, RCC patients with advanced stage and metastasis with higher risk of tVTE, close follow-up is recommended and proactive prophylaxis of VTE might be needed.