Background: The prevalence of venous thromboembolism (VTE) in cancer patients is particularly high at disease progression or relapse, causing additional morbidity. Patients cared for in specialized palliative care units (SPCU) are rarely included in VTE studies, thus the actual impact of VTE and need for prophylaxis in this setting are not well known.

Aims: We studied the prevalence, clinical characteristics, and survival of individuals with VTE.

Methods: We retrospectively included 2301 consecutive individuals with active cancer managed at our SPCU. Data were summarized using descriptive statistics. Overall survival was estimated by Kaplan-Meier and comparisons by log-rank test. Thrombotic events were confirmed by imaging.

Results: We studied 1646 (71.5%) women and 655(28.5%) men. The prevalence of VTE was higher in women (9.7% vs 2.5%), particularly women with gynecological tumors (cervical: 19.2%, breast: 14.7%, ovarian: 13.5%). The overall prevalence of VTE was 12.1%, with only 1.7% occurring after the first consultation in the SPCU. Median overall survival was longer for patients without VTE at 3, 6, and 12 months (48.2%, 34.2%, 23.4%) compared to patients with thrombosis (42.6, 25.1%, 15%).

Conclusions: The prevalence of VTE varied by tumor origin and impacted overall survival. Though median survival was short, some patients were followed over months suggesting that therapeutic anticoagulation to decrease the risk and morbidity of rethrombosis should be considered. On the other hand, few patients developed symptomatic VTE during SPCU care, making generalized primary prophylaxis probably unwarranted. Customizing treatment to the risk of hemorrhage, physical performance, and prognosis is important.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/venous-thromboembolism-in-patients-with-cancer-in-palliative-care/