Incidence and risk factors for venous thromboembolism in the Cancer-VTE Registry stomach cancer subcohort

Background The Cancer-VTE Registry was a large-scale, multicenter, prospective registry designed to investigate real-world data on venous thromboembolism (VTE) incidence and risk factors in adult Japanese patients with solid tumors. This pre-specified subgroup analysis aimed to estimate the incidenc...

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Bibliographic Details
Published in:Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2023-07, Vol.26 (4), p.493-503
Main Authors: Yoshikawa, Takaki, Sano, Takeshi, Terashima, Masanori, Yamaguchi, Kensei, Bando, Etsuro, Kawabata, Ryohei, Yabusaki, Hiroshi, Shinohara, Hisashi, Oba, Mari S., Kimura, Tetsuya, Takita, Atsushi, Sasako, Mitsuru
Format: Article
Language:English
Subjects:
Abdominal Surgery
Adult
Aged
Anticoagulants
Asymptomatic
Cancer Research
Cancer therapies
Cerebral infarction
Chemotherapy
Clinical outcomes
Diagnosis
Female
Gastric cancer
Gastroenterology
Health risks
Humans
Incidence
Ischemia
Medical diagnosis
Medicine
Medicine & Public Health
Neoplasms
Oncology
Original
Original Article
Patients
Registries
Risk Factors
Solid tumors
Stomach
Stomach Neoplasms - complications
Stomach Neoplasms - epidemiology
Stroke
Surgical Oncology
Survival analysis
Thromboembolism
Thrombosis
Transient ischemic attack
UMIN
UMIN000024942
Venous Thromboembolism - epidemiology
Venous Thromboembolism - etiology
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Summary:Background The Cancer-VTE Registry was a large-scale, multicenter, prospective registry designed to investigate real-world data on venous thromboembolism (VTE) incidence and risk factors in adult Japanese patients with solid tumors. This pre-specified subgroup analysis aimed to estimate the incidence of VTE, including VTE types other than symptomatic VTE, and identify risk factors of VTE in stomach cancer from the Cancer-VTE Registry. Methods Stage II–IV stomach cancer patients who planned to initiate cancer therapy and underwent VTE screening within 2 months before registration were enrolled. Results Of 1,896 patients enrolled, 131 (6.9%) had VTE at baseline, but 96.2% were asymptomatic. Female sex, age ≥ 65 years, VTE history, and D-dimer > 1.2 μg/mL were independent risk factors of VTE at baseline. Notably, patients with D-dimer > 1.2 µg/mL at the time of cancer diagnosis had an approximately 20-fold risk of VTE. During follow-up, event incidences were symptomatic VTE, 0.3%; incidental VTE requiring treatment, 1.1%; composite VTE, 1.4%; bleeding, 1.6%; cerebral infarction/transient ischemic attack/systemic embolic events, 0.7%; and all-cause death, 15.0%. The incidence of all-cause death was higher in patients with VTE vs without VTE at baseline (adjusted hazard ratio 1.67; 95% confidence interval 1.21–2.32; p = 0.002). Conclusions VTE prevalence at the time of cancer diagnosis was not negligible and was extremely high when the patients had high D-dimer. VTE screening by D-dimer before starting cancer treatment is advisable, even for asymptomatic patients, regardless of whether the patient is undergoing surgery or chemotherapy. Trial registration UMIN000024942.
ISSN:1436-3291
1436-3305
DOI:10.1007/s10120-023-01378-1