Abstract Number: PB2178
Meeting: ISTH 2020 Congress
Background: Patients with cancer are at high risk of venous thromboembolism (VTE), a risk dependent among others on type and stage of the tumor. Osteosarcoma cells express abundant levels of tissue factor (TF), which may indicate that patients with osteosarcoma are at high risk of cancer-associated venous thromboembolism (CAT). Few studies on the incidence of CAT in osteosarcoma are available in daily clinical practice.
Aims: To assess the cumulative incidence of (symptomatic and incidental) VTE in the clinical course of osteosarcoma and to study its prognostic impact on overall survival.
Methods: We performed a post-hoc chart review of patients diagnosed with osteosarcoma and treated in the Leiden University Medical Center (LUMC) between 1984 and 2018. The institutional review board in Leiden waived the need for informed consent from study participants. Patient charts were scrutinized for index tumor characteristics, clinical patient characteristics and the VTE events. All endpoints were adjudicated by an independent expert.
Results: The baseline characteristics of the 530 included patients are shown in Table 1.The cumulative 24-month incidence of VTE in our cohort of osteosarcoma patients was 9.0% (95%CI 6.5-12). None of the VTE events was fatal. Seventy-four percent of VTE events was symptomatic and the most frequent presentation was upper extremity thrombosis (n=18, 39%); 16/18 of the latter were related to a central venous catheter (Table 2). The overall cumulative 24-month mortality rate was 27% (95%CI 23-30). A diagnosis of VTE was not associated with higher mortality for a crude hazard ratio of 1.4 (95% CI 0.86-2.4).
Conclusions: Osteosarcoma is associated with a considerable incidence of VTE, although mostly related to indwelling catheters. Future studies should be performed to reduce this high incidence of catheter related thrombosis in this young age patient group.
To cite this abstract in AMA style:Stals M, Kaptein FHJ, Evenhuis RE, Gelderblom AJ, Huisman MV, Noten RWD, Versteeg HH, Van de Sande MAJ, Klok FA. Risk of Venous Thromboembolism in the Clinical Course of Osteosarcoma [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/risk-of-venous-thromboembolism-in-the-clinical-course-of-osteosarcoma/. Accessed October 1, 2023.
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