Abstract Number: PB2369
Meeting: ISTH 2020 Congress
Theme: Venous Thromboembolism and Cardioembolism » VTE Prophylaxis
Background: Patients with gastric cancer are at higher risk for venous thromboembolic events (VTE). Majority of such patients are treated in ambulatory settings where thromboprophylaxis is not routinely offered.
Aims: In this study, we search for predictors that may help identify patients at higher risk to justify VTE-prophylaxis in ambulatory settings.
Methods: Patients with pathologically-confirmed gastric adenocarcinoma were retrospectively reviewed for radiologically-detected VTE. Clinical and pathological features known to increase the risk of VTE were studied.
Results: A total of 671 patients; median age (range) 55 (18-95) years, were recruited. During course of their disease, 150 (22.4%) patients had VTE, including 42 (28.0%) pulmonary embolism (PE) and 18 (12.0%) upper extremity DVT. Majority (n=112, 74.7%) had their clot in ambulatory settings and none had been on thromboprophylaxis. Venous thromboembolic rate was higher (n=99, 27.1%) in patients with metastatic disease (n=365), compared to 51 (16.7%) of those with nonmetastatic disease (n=306), p=0.010. Additionally, VTE rate was higher (n=93, 31.3%) among patients with high Khorana risk score (n=297) compared to 54 (17.3%) in those with intermediate score (n=312), p=0.001. However, rates of VTE were similar in active smokers (20.1%) and those who never smoked (21.6%), p=0.485 and in obese (BMI ≥30) patients (29.0%) compared to 21.9% among those with BMI < 30, p=0.282. Chemotherapy, including platinum, in patient with metastatic or nonmetastatic disease had no significant impact on VTE rates. In multivariate analysis, stage IV disease (Odd Ratio [OR], 2.084; 95% CI: 1.28-3.39, p=0.003) and high Khorana risk score
(OR, 2.63; 95% CI: 1.64-4.23, p< 0.0001) were associated with significantly high VTE rates.
Conclusions: Patients with gastric cancer have notably high rate of VTE. Metastatic disease and high Khorana risk score are associated with even higher rates that may justify VTE prophylaxis, even in ambulatory settings, when the risk of bleeding is not high.
To cite this abstract in AMA style:
Abdel-Razeq H, Altell A, Sharf B, Braik D, Mustafa R, Ashouri K, Omari Z, Shaqboua H, Jaradat S, Alqasem K, Mansour R, Abdel-Razeq R, Bater R. Prevalence and Predictors of Thromboembolic Events in Patients with Gastric Cancer [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/prevalence-and-predictors-of-thromboembolic-events-in-patients-with-gastric-cancer/. Accessed March 21, 2024.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/prevalence-and-predictors-of-thromboembolic-events-in-patients-with-gastric-cancer/