Incidence and Outcomes Associated with 6,841 Isolated Distal Deep Vein Thromboses in Patients with 13 Common Cancers

Anjlee Mahajan; Ann Brunson; Joanna Eldredge; Richard H. White; Theresa H. M. Keegan; Ted Wun

doi:10.1055/a-1742-0177

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2022; 122(08): 1407-1414
DOI: 10.1055/a-1742-0177

Stroke, Systemic or Venous Thromboembolism

Incidence and Outcomes Associated with 6,841 Isolated Distal Deep Vein Thromboses in Patients with 13 Common Cancers

Anjlee Mahajan

¹Division of Hematology and Oncology, Center for Oncology Hematology Outcomes Research and Training , University of California Davis School of Medicine, Sacramento, California, United States

,

Ann Brunson

¹Division of Hematology and Oncology, Center for Oncology Hematology Outcomes Research and Training , University of California Davis School of Medicine, Sacramento, California, United States

,

Joanna Eldredge

¹Division of Hematology and Oncology, Center for Oncology Hematology Outcomes Research and Training , University of California Davis School of Medicine, Sacramento, California, United States

,

Richard H. White

²Division of General Internal Medicine, UC Davis School of Medicine, Sacramento, California, United States

,

Theresa H. M. Keegan

¹Division of Hematology and Oncology, Center for Oncology Hematology Outcomes Research and Training , University of California Davis School of Medicine, Sacramento, California, United States

,

Ted Wun

¹Division of Hematology and Oncology, Center for Oncology Hematology Outcomes Research and Training , University of California Davis School of Medicine, Sacramento, California, United States

³UC Davis Clinical and Translational Science Center, Sacramento, California, States

› Author Affiliations

Abstract

Introduction The epidemiology of isolated distal deep venous thrombosis (iDDVT) among cancer patients is not well described, particularly the incidence of recurrent venous thromboembolism (rVTE) and effect on mortality by cancer type.

Methods The cumulative incidence (CI) of iDDVT was determined for patients with 13 common cancers between 2005 and 2017 using the California Cancer Registry linked to the California Patient Discharge and Emergency Department Utilization datasets. The CI of rVTE was calculated and association of incident cancer-associated thrombosis (CT) location with rVTE was determined using Cox proportional hazards regression models. The association of incident CT location with overall and cancer-specific mortality was determined using Cox models, stratified by cancer site, and adjusted for individual characteristics.

Results Among 942,109 cancer patients, CT occurred in 62,003 (6.6%): of these, 6,841 (11.0%) were iDDVT. Compared with more proximal sites of CT, iDDVT was associated with similar risk for rVTE. IDDVT was associated with increased mortality across all cancer types when compared with patients without CT (hazard ratio: 1.56–4.60). The effect of iDDVT on mortality was similar to that of proximal DVT (pDVT) for most cancers except lung, colorectal, bladder, uterine, brain, and myeloma, where iDDVT was associated with a lesser association with mortality.

Conclusion iDDVT represented 11% of CT. The risk of rVTE after iDDVT was similar to other sites of CT and rVTE occurred in more proximal locations after an incident iDDVT. IDDVT was associated with increased mortality and this effect was similar to that of pulmonary embolism or pDVT for most cancer types.

Keywords

distal deep vein thrombosis - venous thromboembolism - cancer

Full Text

References

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Supplementary Material