Affiliation:
1. Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
2. The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
Abstract
Purpose To investigate the differences in survival after venous thromboembolism (VTE) and anticoagulation efficacy and safety between catheter (CRVTE) and non-catheter-related VTE (NCRVTE) in cancer patients. Methods A retrospective research was conducted, and consecutive cancer (digestive, respiratory, genitourinary, blood and lymphatic, and the other cancers) patients with VTE were enrolled. The anticoagulation therapies included low-molecular-weight heparin (LMWH), warfarin, new type of direct oral anticoagulants (NDOACs), LMWH combined with warfarin, and LMWH combined with NDOACs. Data were collected from the electronic medical record database of our hospital and were analyzed accordingly by Kruskal-Wallis H Test, Chi-square test, Fisher's exact test, Logistic regressions, Kaplan-Meier analysis, and Cox regressions. Results 263 patients were included, median age in years (interquartile range) was 64(56-71) and 60.5% were male. VTE recurrence rate was 16.7% in CRVTE group which was significantly lower than 34.8% in NCRVTE group ( P = .032). Heart diseases were independently associated with VTE recurrence ( P = .025). Kaplan-Meier survival estimates at 1, 2, and 3 years for CRVTE group were 62.5%, 60.0%, and 47.5%, respectively, compared with 47.9% ( P = .130), 38.7% ( P = .028), and 30.1% ( P = .046), respectively, for NCRVTE group. Cox regression showed surgery ( P = .003), anticoagulation therapy types ( P = .009), VTE types ( P = .006) and cancer types ( P = .039) were independent prognostic factors for 3-year survival after VTE. Nonmajor and major bleeding were not significantly different ( P = .417). Anticoagulation therapy types were independently associated with the bleeding events ( P = .030). Conclusions Cancer patients with CRVTE potentially have a better anticoagulation efficacy and survival compared to NCRVTE, and the anticoagulation safety seems no significant difference.
Funder
the Medical and Health Science and Technology Project of Zhejiang Province
Traditional Chinese Medicine Science and Technology Project of Zhejiang Province