Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival
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- dc.contributor.author Ramos, Jorge D.ca
- dc.contributor.author Bellmunt Molins, Joaquim, 1959-ca
- dc.contributor.author Yu, Evan Y.ca
- dc.date.accessioned 2017-12-01T08:20:24Z
- dc.date.available 2017-12-01T08:20:24Z
- dc.date.issued 2017
- dc.description.abstract 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.
- dc.format.mimetype application/pdfca
- dc.identifier.citation Ramos JD, Casey MF, Crabb SJ, Bamias A, Harshman LC, Wong YN. T al. Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival. Cancer Med. 2017 Jan;6(1):186-194. DOI: 10.1002/cam4.986
- dc.identifier.doi http://dx.doi.org/10.1002/cam4.986
- dc.identifier.issn 2045-7634
- dc.identifier.uri http://hdl.handle.net/10230/33426
- dc.language.iso eng
- dc.publisher Wileyca
- dc.relation.ispartof Cancer Medicine. 2017 Jan;6(1):186-94
- dc.relation.ispartof Cancer Medicine. 2017 Jan;6(1):186-94
- dc.rights TThis is an open access article under the terms of https://creativecommons.org/licenses/by/4.0/, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.subject.keyword Urothelial;
- dc.subject.keyword Bladder cancer
- dc.subject.keyword Chemotherapy survival
- dc.subject.keyword Venous thromboembolism
- dc.subject.other Venous thromboembolism
- dc.subject.other Bufeta -- Càncer
- dc.subject.other Trombosi -- Tractament
- dc.title Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survivalca
- dc.type info:eu-repo/semantics/article
- dc.type.version info:eu-repo/semantics/publishedVersion