OBJECTIVES

: This analysis aimed to identify the associated factors affecting recurrence of Venous Thromboembolism(VTE) and Bleeding in Cancer patients with VTE in Korea

METHODS

: Data for this analysis was from a retrospective cohort study conducted at 8 nationwide, tertiary hospitals of Korea from 2013 to 2015. Patients who aged ≥19 years, have active cancer, cancer-associated deep vein thrombosis or pulmonary embolism, and on anticoagulants, were enrolled and observed for 1year. Data was extracted from the medical chart. Patients demography, clinical characteristics, treatment patterns were considered as potential factors in this analysis. Treatment patterns were classified into 3 patterns; Guideline-Based Practice(GBP)-started with low molecular weight heparin(LMWH) monotherapy and continued it for consecutive 3 to 6months; non-GBP-Direct oral anticoagulants(DOAC) (non-GBP-D)- initial anticoagulant was DOAC monotherapy and treated for the following 3 to 6months; non-GBP others(non-GBP-O)-the remaining treatment patterns other than GBP and non-GBP-D. We performed competing risk analysis to assess factors associated with clinical outcomes.

RESULTS

: Total 623 patients(age:63.7±11.3, male:49.3%) after excluding 125patients who lost follow-up, died, and discontinued VTE treatment pattern within the first 3months were included in this analysis. The risk factors associated with VTE recurrence were ECOG performance status 3,4 (HR:0.49, P<0.01) compared to ECOG performance status 0, creatinine clearance(Crcl)(30.0≤Crcl<50.0)(HR:0.29, P=0.011) compared to Creatinine clearance(Crcl) ≥ 80.0 and the involvement of main pulmonary artery in initial VTE (HR:1.82, P=0.024). Meanwhile, no insertion of central catheter(HR:0.53, P<0.01) was negatively associated with bleeding occurrence and treating VTE with anticoagulants defined as in non-GBP-O increased bleeding risk 3.59 fold higher than GBP(P<0.01).

CONCLUSIONS :

This analysis identified several factors associated with clinical outcomes of VTE recurrence, and bleeding in cancer patients with VTE. These results can be concrete evidence to support previous study findings. Those defined factors should be considered in development of treatment strategy for patients’ better outcomes.