Concurrent VTE with cancer tied to greater mortality risk: Lancet
Venous thromboembolism, a predominant disease of the elderly, encompasses deep venous thrombosis and pulmonary embolism. Its association with cancer has been known for almost 200 years. According to data, cancer patients have a nine-fold higher venous thromboembolism risk. According to a nationwide study published in The Lancet Regional Health Europe, venous thromboembolism in cancer patients has a strong association with a poor prognosis despite improvement in cancer treatment.
This study was a nationwide, population-based, retrospective cohort study including 887,000 patients with cancer during 1995-2018 in Danish registries. The researchers considered the evidence from cohort studies on the association between venous thromboembolism and cancer patients' survival and searched the MEDLINE database. Previous Studies have demonstrated a two to three-fold increased risk of death in cancer patients with venous thromboembolism compared to those without venous thromboembolism.
There needs to be more data on the strength of this association and long-term survival. In a large population-based cohort study, this study determined the five-year mortality of venous thromboembolism in cancer patients.
The key findings of this study are:
- Cancer was diagnosed in 886,536 patients during the study period.
- Of 1882 cancer patients diagnosed at the time of their venous thromboembolism, 835 patients, constituting 44.4%, had distant metastases.
- In the concurrent group, the one- and five-year mortality cumulative incidences were 68% and 84% versus 38% and 67% in the comparison cohort.
- The mortality rate ratio was 4.34 and 3.44 for the first and five-year follow-ups, respectively.
- Of the 23,366 patients diagnosed with venous thromboembolism after cancer diagnosis, 18% had distant metastases at the time of cancer diagnosis.
- The cumulative incidence of death at one year and five years was 45% and 69 %, respectively.
- The mortality rate ratio was 3.48 and 2.57, respectively.
Venous thromboembolism remains a strong predictor for a worse prognosis, and cancer-associated venous thromboembolism is a serious complication in cancer patients despite substantial improvements in cancer treatment in recent decades.
The research highlights the prognostic significance of cancer-associated venous thromboembolism for mortality in the era of modern cancer therapy.
This study's limitation includes retrospective and observational design. Independent Research Fund Denmark and the Karen Elise Jensen Foundation supported the study.
Reference:
Sørensen, H. T., Pedersen, L., Van Es, N., Büller, H. R., & Horváth‐Puhó, E. (2023). Impact of venous thromboembolism on the mortality in patients with cancer: a population-based cohort study. The Lancet Regional Health - Europe, 34, 100739. https://doi.org/10.1016/j.lanepe.2023.100739
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