OBJECTIVES

Cancer Venous Thromboembolism(VTE) outcomes research investigated clinical characteristics, treatment patterns, and clinical outcomes of VTE recurrence and bleeding among cancer patients with VTE. Here we report clinical characteristics and treatment patterns from the study.

METHODS

Cancer VTE outcomes research was a retrospective cohort study conducted at 8 nationwide, tertiary hospitals of Korea. The study included adult cancer patients(>19 years) who were diagnosed as VTE between 2013 and 2015 and must meet following criteria;1)Active cancer,2)pulmonary Embolism(PE) or Deep Vein Thrombosis(DVT) in the lower half of the body,3)VTE treatment for at least 15-day,4)no history of anticoagulant use a month before VTE treatment. Exclusion criteria;1)participated in VTE-related drug interventional studies,2)had VTE other than cancer-related,3)concomitantly take other medications/treatment. Data were collected through medical chart review.

RESULTS

A total of 753 patients were enrolled(male:50.6%, age:64). Of total, 71.7% of patients had one or more comorbid diseases(Infection:35.5%, Anemia:35.5%). The mean duration of cancer was 1.5 years with recurrence for about 24%. The most common cancers were in Lung(24.4%) followed by Colon/Rectum(15.8%), and Stomach(11.4%). At baseline, 42% of patients had level 1 ECOG performance status. DVT and PE were in 507 and 833patients respectively(allowed multiple choices). Creatinine clearance, homocysteine, hemoglobin, red blood cell, and INR were lower than normal range; Platelet and D-dimer were higher than normal range. Most of patients experienced hospitalization(95.7%), chemotherapy(87.4%), radiation therapy(71.4%) and central venous catheterization(43.0%). 26% of patients received a major surgery within the past 3months. For VTE treatment, LMWH, DOAC, UFH and Warfarin were prescribed for 580(77%), 336(44.6%), 199(26.4%), 147(19.5%)patients respectively.

CONCLUSIONS

Despite treatment guidelines recommend LMWH as initial treatment for Cancer VTE patients, 23% of patients were initially treated with other anticoagulants. More attention should be taken into selection of initial treatment in real practice.