Original articles / Online first

Cancer associated thrombosis: comparison of characteristics, treatment, and outcomes in oncological and non-oncological patients followed by Pulmonary Embolism Response Team

Arkadiusz Pietrasik, Aleksandra Gąsecka, Paweł Kurzyna, Julia M. Smyk, Marcin Wasilewski, Rafał Wolański, Katarzyna Wrona, Szymon Darocha, Dariusz Zieliński, Marcin Grabowski, Adam Torbicki, Marcin Kurzyna
Published online: February 03, 2023


Introduction: The risk of venous thromboembolism (VTE) in cancer is currently 12 times higher than in the general population and even 23 times higher when receiving chemotherapy. The main goal of pulmonary embolism response team (PERT) is to improve prognosis through interdisciplinary care, with a particular focus on patients with contraindications to standard pharmacological treatment, requiring individual decision-making, including wider use of interventional methods of therapy.

Objectives: The objectives of the study were to report and compare the characteristics and outcomes of pulmonary embolism patients with and without cancer treated by PERT-CELZAT.

Patients and methods: The analysis included 235 patients diagnosed with VTE who were consulted by local PERT between September 2017 and December 2021. The study group was divided into two cohorts: oncological patients (OP) and non-oncological patients (NOP). There were 81 patients in the OP group (median age, 68 years) and 154 patients in the NOP group (median age, 57 years).

Results: OP were older and were more frequently diagnosed with incidental PE. In-hospital mortality among all patients reached 6.4% (15/235 patients), 3.7% in OP and 7.8% in NOP (p=0.27). In-hospital events: major bleeding, minor bleeding, recurrent PE, and DVT occurred with similar frequency in both patient groups. Post-hospital mortality up to 12 months after diagnosis was 12.8% (10/78) in OP and 4.2% (6/142) in NOP (p=0.03). In long-term survival analysis cancer was associated with increased risk of mortality (HR 2.44 [1.51-3.95]; p<0.001) when adjusted to age.

Conclusions: The multidisciplinary therapeutical approach may provide cancer patients with VTE an in-hospital survival rate that is no worse than for NOP. OP die more often in the following months, because of their underlying neoplastic disease.

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