OC 64.2 - Trends in clinical characteristics, treatment and 30-day outcomes in cancer patients with venous thromboembolism from 2001 to 2020

Tuesday, June 27, 2023

15:00 – 15:15 ET

Room: 511

Session Available As: On-Demand

Presenting Author(s)

Laurent Bertoletti, MD, PhD (he/him/his)

MD, PhD
Service de Médecine Vasculaire et Thérapeutique, Centre Hospitalo-Universitaire de Saint-Etienne ; INSERM CIC 1408 CHU de St-Etienne; INSERM UMR 1059, Université Jean Monnet, Saint-Etienne ; FCRIN INNOVTE, France.
Saint-Etienne, Rhone-Alpes, France

Co-Author(s)

OM

Olga Madridano

Dr
Department of Internal Medicine, Hospital Infanta Sofía, Madrid, Spain
Madrid, Castilla y Leon, Spain
David Jimenez, PhD

Professor
Hospital Ramon y Cajal
Madrid, Madrid, Spain
AM

Alfonso Muriel

Expert statistician
Hospital Ramon y Cajal
Madrid, Madrid, Spain
Behnood Bikdeli

Associate Physician, Section of Cardiovascular Medicine
Brigham and Women's Hospital, Harvard Medical School
Boston, Massachusetts, United States
Cihan Ay, MD (he/him/his)

Professor, Head of the Thrombosis and Haemostasis Research Group
Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
Vienna, Wien, Austria
JT

Javier Trujillo-Santos

Dr
Internal Medicine Department. Hospital Universitario Santa Lucía. Complejo Hospitalario Universitario de Cartagena. Murcia.
Cartagena, Murcia, Spain
Marijan Bosevski, PhD

Post Doc
University Cardiology Clinic Faculty of Medicine, Skopje, N. Macedonia
Skopje, Skopje, Macedonia
PS

Patricia Sigüenza

Dr
Department of Internal Medicine, Hospital Germans Trias I Pujol, Badalona, Barcelona, Spain
Barcelona, Catalonia, Spain
Manuel Monreal, PhD, MD

Senior consultant
Universidad Catolica de Murcia
Barcelona, Catalonia, Spain

Background: Despite advances in the management of cancer and venous thromboembolism (VTE), it is unclear if cancer-associated thrombosis management and evolution changed over time.

Aims: We used data from the RIETE registry between 2001 and 2020 to analyze temporal trends in clinical characteristics and treatments.

Methods: Using multivariable logistic regression, we examined temporal trends in risk-adjusted rates of VTE recurrences, major bleeding and death within 30 days from incident VTE.

Results: Among 17,271 patients with cancer and VTE, there was an increase over time in the proportion of patients presenting with pulmonary embolism (from 44% in 2001-2005 to 55% in 2016-2020; p < 0.001 for trend), with lung (from 12.7% to 18.1%; p < 0.001) or pancreatic cancer (from 3.8% to 5.6%; p=0.003), or in the use of immunotherapy (from zero to 7.4%; p < 0.001), and a decrease in patients with prostate (from 11.7% to 6.6%; p < 0.001) or carcinoma of unknown origin (from 3.5% to 0.7%; p < 0.001). At 30-day follow-up after VTE diagnosis, there was a decrease in the proportion of patients developing VTE recurrences (from 3.1% to 1.1%; p < 0.001), major bleeding (from 3.1% to 2.2%; p=0.004) or death (from 11.9% to 8.4%; p < 0.001). On multivariable analyses, there was a decrease over time on the risk for VTE recurrences (adjusted subHazard ratio [asHR]: 0.95 per year; 95%CI: 0.93-0.97), major bleeding (asHR: 0.97; 95%CI: 0.95-0.99) or death (aHR: 0.96; 95%CI: 0.95-0.98).

Conclusion(s): In this multicenter study of cancer patients with VTE, thrombotic, hemorrhagic, and fatal events declined from 2001 to 2020.

Learning Objectives:

Upon completion, participant will be able to analyze the trends in the presentation of venous thromboembolism in patients with cancer, during the past 20 years
Upon completion, participant will be able to examine the trends in the 30 days outcomes of venous thromboembolism in patients with cancer, during the past 20 years
Upon completion, participant will be able to summarize the trends in the antithrombotic management of patients with venous thromboembolism and cancer, during the past 20 years