Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival
Venous thromboembolism (VTE) is common in cancer patients. However, little is known about VTE risk in metastatic urothelial carcinoma or variant histologies (UC/VH). We sought to characterize the incidence, associative factors, including whether various chemotherapy regimens portend different risk,...
| Authors: | ; ; |
|---|---|
| Format: | Article |
| Status: | Published version |
| Publication date: | 2017 |
| Country: | España |
| Institution: | Universitat Pompeu Fabra |
| Repository: | Repositorio Digital de la UPF |
| OAI Identifier: | oai:repositori.upf.edu:10230/33426 |
| Online Access: | http://hdl.handle.net/10230/33426 http://dx.doi.org/10.1002/cam4.986 |
| Access Level: | Open access |
| Keyword: | Venous thromboembolism Bufeta -- Càncer Trombosi -- Tractament Urothelial Bladder cancer Chemotherapy survival |
| _version_ | 1878735505131044864 |
|---|---|
| author | Ramos, Jorge D. |
| author2 | Bellmunt Molins, Joaquim, 1959- Yu, Evan Y. |
| author2_role | author author |
| author_browse | Bellmunt Molins, Joaquim, 1959- Ramos, Jorge D. Yu, Evan Y. |
| author_facet | Ramos, Jorge D. Bellmunt Molins, Joaquim, 1959- Yu, Evan Y. |
| author_role | author |
| collection | Repositorio Digital de la UPF |
| description | Venous thromboembolism (VTE) is common in cancer patients. However, little is known about VTE risk in metastatic urothelial carcinoma or variant histologies (UC/VH). We sought to characterize the incidence, associative factors, including whether various chemotherapy regimens portend different risk, and impact of VTE on survival in metastatic UC/VH patients. Patients diagnosed with metastatic UC/VH from 2000 to 2013 were included in this multicenter retrospective, international study from 29 academic institutions. Cumulative and 6-month VTE incidence rates were determined. The association of first-line chemotherapy (divided into six groups) and other baseline characteristics on VTE were analyzed. Each chemotherapy treatment group and statistically significant baseline clinical characteristics were assessed in a multivariate, competing-risk regression model. VTE patients were matched to non-VTE patients to determine the impact of VTE on overall survival. In all, 1762 patients were eligible for analysis. There were 144 (8.2%) and 90 (5.1%) events cumulative and within the first 6 months, respectively. VTE rates based on chemotherapy group demonstrated no statistical difference when gemcitabine/cisplatin was used as the comparator. Non-urotheilal histology (SHR: 2.67; 95% CI: 1.72-4.16, P < 0.001), moderate to severe renal dysfunction (SHR: 2.12; 95% CI: 1.26-3.59, P = 0.005), and cardiovascular disease (CVD) or CVD risk factors (SHR: 2.27; 95% CI: 1.49-3.45, P = 0.001) were associated with increased VTE rates. Overall survival was worse in patients with VTE (median 6.0 m vs. 10.2 m, P < 0.001). Thus, in metastatic UC/VH patients, VTE is common and has a negative impact on survival. We identified multiple associated potential risk factors, although different chemotherapy regimens did not alter risk. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_7e00fffe07a770cc22e7e968a1d6b102 |
| institution | Universitat Pompeu Fabra |
| instname_str | Universitat Pompeu Fabra |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:repositori.upf.edu:10230/33426 |
| publishDate | 2017 |
| publishDateSort | 2017 |
| publisher | Wiley |
| publisherStr | Wiley |
| reponame_str | Repositorio Digital de la UPF |
| spelling | Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival Ramos, Jorge D. Bellmunt Molins, Joaquim, 1959- Yu, Evan Y. Venous thromboembolism Bufeta -- Càncer Trombosi -- Tractament Urothelial Bladder cancer Chemotherapy survival Venous thromboembolism (VTE) is common in cancer patients. However, little is known about VTE risk in metastatic urothelial carcinoma or variant histologies (UC/VH). We sought to characterize the incidence, associative factors, including whether various chemotherapy regimens portend different risk, and impact of VTE on survival in metastatic UC/VH patients. Patients diagnosed with metastatic UC/VH from 2000 to 2013 were included in this multicenter retrospective, international study from 29 academic institutions. Cumulative and 6-month VTE incidence rates were determined. The association of first-line chemotherapy (divided into six groups) and other baseline characteristics on VTE were analyzed. Each chemotherapy treatment group and statistically significant baseline clinical characteristics were assessed in a multivariate, competing-risk regression model. VTE patients were matched to non-VTE patients to determine the impact of VTE on overall survival. In all, 1762 patients were eligible for analysis. There were 144 (8.2%) and 90 (5.1%) events cumulative and within the first 6 months, respectively. VTE rates based on chemotherapy group demonstrated no statistical difference when gemcitabine/cisplatin was used as the comparator. Non-urotheilal histology (SHR: 2.67; 95% CI: 1.72-4.16, P < 0.001), moderate to severe renal dysfunction (SHR: 2.12; 95% CI: 1.26-3.59, P = 0.005), and cardiovascular disease (CVD) or CVD risk factors (SHR: 2.27; 95% CI: 1.49-3.45, P = 0.001) were associated with increased VTE rates. Overall survival was worse in patients with VTE (median 6.0 m vs. 10.2 m, P < 0.001). Thus, in metastatic UC/VH patients, VTE is common and has a negative impact on survival. We identified multiple associated potential risk factors, although different chemotherapy regimens did not alter risk. Wiley http://hdl.handle.net/10230/33426 http://dx.doi.org/10.1002/cam4.986 |
| spellingShingle | Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival Ramos, Jorge D. Venous thromboembolism Bufeta -- Càncer Trombosi -- Tractament Urothelial Bladder cancer Chemotherapy survival |
| status_str | publishedVersion |
| title | Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival |
| title_full | Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival |
| title_fullStr | Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival |
| title_full_unstemmed | Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival |
| title_short | Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival |
| title_sort | Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival |
| topic | Venous thromboembolism Bufeta -- Càncer Trombosi -- Tractament Urothelial Bladder cancer Chemotherapy survival |
| topic_facet | Venous thromboembolism Bufeta -- Càncer Trombosi -- Tractament Urothelial Bladder cancer Chemotherapy survival |
| url | http://hdl.handle.net/10230/33426 http://dx.doi.org/10.1002/cam4.986 |