TY  - JOUR
A1  - Langer, Florian
A1  - Gerlach, Horst E.
A1  - Schimke, Alexandra
A1  - Heinken, Andreas
A1  - Hoffmann, Ulrich
A1  - Noppeney, Thomas
A1  - Pittrow, David
A1  - Klotsche, Jens
A1  - Rabe, Eberhard
A1  - Bauersachs, Rupert
T1  - Clinical outcomes of cancer-associated isolated superficial vein thrombosis in daily practice
T2  - Thrombosis research
N2  - Highlights
• In acute isolated SVT, the prevalence of cancer is almost 7 %.
• Cancer increases the SVT-associated VTE risk at 3 and 12 months.
• Cancer patients with isolated SVT may benefit from prolonged anticoagulation.
Abstract
Background: Despite significant progress in the understanding of paraneoplastic deep vein thrombosis (DVT) and pulmonary embolism (PE), little is known about the outcomes of cancer-associated superficial vein thrombosis (SVT) in daily practice.
Methods: INSIGHTS-SVT was a prospective observational study on patients with acute isolated SVT. Primary outcome measure was symptomatic venous thromboembolism (VTE), a composite of DVT, PE, and SVT extension/recurrence, at 3 months. Clinically relevant bleeding was also assessed.
Results: Of 1151 patients included, 6.7 % either had active cancer at baseline or were diagnosed with cancer during 12 months of follow-up. At 3 months, symptomatic VTE had occurred in 13.0 % and 5.4 % of cancer and non-cancer patients, respectively (HR 2.6, 95 % CI 1.3–5.0). Regarding secondary outcomes, cancer patients had increased risks of DVT and PE (HR 3.9, 95 % CI 1.3–11.8) and hospitalization due to VTE (HR 11.0, 95 % CI 2.5–49.0). The rate of clinically relevant bleeding was numerically higher in the cancer cohort (3.9 % vs 1.3 %, HR 3.1, 95 % CI 0.9–10.7). At 12 months, the primary composite outcome had occurred in 15.6 % and 11.9 % of cancer and non-cancer patients, respectively (HR 1.9, 95 % CI 1.0–3.5). After adjusting for additional risk factors, including age, history of DVT/PE and cardiovascular risk factors/diseases, the association of cancer with the primary outcome remained statistically significant.
Conclusion: Cancer patients with isolated SVT are at significant risk of symptomatic VTE. While most events occur within 3 months, the VTE risk remains elevated up to one year of follow-up.
ClinicalTrials.gov identifier: NCT02699151.
KW  - Superficial vein thrombosis
KW  - Malignancy
KW  - Cancer
KW  - Risk assessment
KW  - Observational
KW  - Venous thrombosis
KW  - Low-molecular-weight heparin
KW  - Fondaparinux
KW  - Treatment
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/78620
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-786201
SN  - 0049-3848
VL  - 220
SP  - 145
EP  - 152
PB  - Elsevier
CY  - Amsterdam [u.a.]
ER  -