Cancer associated thrombosis in everyday practice: perspectives from GARFIELD-VTE

Jeffrey Weitz*, Sylvia Haas, Walter Ageno, Samuel Z. Goldhaber, Alexander G. G. Turpie, Shinya Goto, Pantep Angchaisuksiri, Jorn Dalsgaard Nielsen, Gloria Kayani, Alfredo E. Farjat, Sebastian Schellong, Henri Bounameaux, Lorenzo G. Mantovani, Paolo Prandoni, Ajay K. Kakkar, GARFIELD-VTE Investigators, Hugo ten Cate

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

20 Citations (Web of Science)

Abstract

Venous thromboembolism (VTE) is common in cancer patients and is an important cause of morbidity and mortality. The Global Anticoagulant Registry in the FIELD (GARFIELD)-VTE (ClinicalTrials.gov: NCT02155491) is a prospective, observational study of 10,684 patients with objectively diagnosed VTE from 415 sites in 28 countries. We compared baseline characteristics, VTE treatment patterns, and 1-year outcomes (mortality, recurrent VTE and major bleeding) in 1075 patients with active cancer, 674 patients with a history of cancer, and 8935 patients without cancer. Patients with active cancer and history of cancer were older than cancer-free patients, with median ages of 64.8, 68.9, and 58.4 years, respectively. The most common sites of active cancer were lung (14.5%), colorectal (11.0%), breast (10.6%), and gynaecological (10.3%). Active cancer patients had a higher incidence of upper limb and vena cava thrombosis than cancer-free patients (9.0% vs 4.8% and 5.1% vs 1.4%, respectively), and were more likely to receive parenteral anticoagulation as monotherapy than cancer-free patients (57.8% vs 12.1%), and less likely to receive DOACs (14.2% vs 50.6%). Rates of death, recurrent VTE, and major bleeding were higher in active cancer patients than in cancer-free patients, with hazard ratios (95% confidence intervals) of 14.2 (12.1-16.6), 1.6 (1.2-2.0) and 3.8 (2.9-5.0), respectively. VTE was the second most common cause of death in patients with active cancer or history of cancer. In patients with VTE, those with active cancer are at higher risk of death, recurrence, and major bleeding than those without cancer.

Original languageEnglish
Pages (from-to)267-277
Number of pages11
JournalJournal of Thrombosis and Thrombolysis
Volume50
Issue number2
DOIs
Publication statusPublished - Aug 2020

Keywords

  • Cancer
  • Malignancy
  • Venous thromboembolism
  • Anticoagulation
  • Registry
  • CLINICAL-PRACTICE GUIDELINES
  • DEEP-VEIN THROMBOSIS
  • VENOUS THROMBOEMBOLISM
  • RISK-FACTORS
  • MANAGEMENT
  • PROPHYLAXIS
  • REGISTRY

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