CLINICAL CHARACTERISTICS AND PROGNOSIS OF PATIENTS WITH CANCER-ASSOCIATED THROMBOSIS

Emilija Lazarova Trajkovska; Emilija Antova; Elizabeta Srbinovska Kostovska

Emilija Lazarova Trajkovska UC National Center for Cardiovascular Diseases, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia
Emilija Antova UC National Center for Cardiovascular Diseases, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia
Elizabeta Srbinovska Kostovska UC National Center for Cardiovascular Diseases, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia

Abstract

Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (BE), is a very common and potentially fatal disease. The incidence of VTE in cancer patients is about 4–7 times higher compared to healthy individuals and appears to increase over time. The aim of this study is to evaluate the clinical characteristics and prognosis of patients with cancer-associated thrombosis. Material and methods: This prospective observational single-center clinical study enrolled 20 patients with active cancer, divided into 3 groups, according to the location of thrombosis: deep vein thrombosis (DVT), pulmonary embolism (PE), and DVT with PE. Clinical characteristics between these three groups and their prognosis were compared. Results: The study included 20 patients, of whom 9 (45%) were women and 11 (55%) were men, with a mean age of 54 ±13.7 years. The prevalence of risk factors and comorbidities was determined:10 patients had hypertension (50%), 6 patients had chronic kidney disease (30%), 3 patients had diabetes (15%), 2 patients had hepatic lesion (10%). Smoking was observed in 8 patients (40%).Uurogenital carcinoma was predominantly present in 4 patients, with ovarian cancer and 1 patient with cervical uterine carcinoma (25%). In men, prostate cancer was present in 3 patients (15%), while testicular cancer in 1 patient (5%). Kidney cancer had 2 patients (10%). Breast cancer accounted for 15% (3 patients), 3 patients or 15% were with colon cancer and 2 patients or 10% with pancreatic cancer and lung cancer in 1 patient (5%). PTE was diagnosed in 13 patients (65%), DVT alone was detected in 9 patients (45%), and combined DVT with PTE was reported in 2 patients (10%). DOACs were administered as home therapy in 55% (11 patients). 7 patients (35%) were treated with LMWH, and only 4 patients (20%) were prescribed with VKA. Conclusion: The use of DOACs is an effective and safe treatment option for VTE in selected cancer patients. LMWH remain a treatment option in patients with cancer at high risk of bleeding, such as patients with gastrointestinal and genitourinary cancer, patients with chemotherapy-induced thrombocytopenia, patients receiving anticancer therapies with potential interactions with DOAC and those with brain metastases.

Keywords: venous thromboembolism, cancer, DOAC.

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