Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival
Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival
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.
Journal Article
186-194
Ramos, Jorge D.
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Casey, Martin F.
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Crabb, Simon J.
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Bamias, Aristotelis
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Harshman, Lauren C
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Wong, Yu-Ning
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Bellmunt, Joaquim
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De Giorgi, Ugo
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Ladoire, Sylvain
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Powles, Thomas
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Pal, Sumanta K.
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Niegisch, Guenter
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Recine, Federica
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Alva, Ajjai
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Agarwal, Neeraj
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Necchi, Andrea
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Vaishampayan, Ulka N.
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Rosenberg, Jonathan E.
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Galsky, Matthew D.
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Yu, Evan Y.
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January 2017
Ramos, Jorge D.
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Casey, Martin F.
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Crabb, Simon J.
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Bamias, Aristotelis
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Harshman, Lauren C
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Wong, Yu-Ning
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Bellmunt, Joaquim
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De Giorgi, Ugo
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Ladoire, Sylvain
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Powles, Thomas
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Pal, Sumanta K.
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Niegisch, Guenter
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Recine, Federica
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Alva, Ajjai
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Agarwal, Neeraj
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Necchi, Andrea
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Vaishampayan, Ulka N.
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Rosenberg, Jonathan E.
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Galsky, Matthew D.
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Yu, Evan Y.
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Ramos, Jorge D., Casey, Martin F., Crabb, Simon J., Bamias, Aristotelis, Harshman, Lauren C, Wong, Yu-Ning, Bellmunt, Joaquim, De Giorgi, Ugo, Ladoire, Sylvain, Powles, Thomas, Pal, Sumanta K., Niegisch, Guenter, Recine, Federica, Alva, Ajjai, Agarwal, Neeraj, Necchi, Andrea, Vaishampayan, Ulka N., Rosenberg, Jonathan E., Galsky, Matthew D. and Yu, Evan Y.
,
RISC Investigators
(2017)
Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival.
Cancer Medicine, 6 (1), .
(doi:10.1002/cam4.986).
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.
Text
CAM4-6-186
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Accepted/In Press date: 27 October 2016
e-pub ahead of print date: 20 December 2016
Published date: January 2017
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Journal Article
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Local EPrints ID: 412845
URI: http://eprints.soton.ac.uk/id/eprint/412845
ISSN: 2045-7634
PURE UUID: 7f88142c-41c9-4208-8c10-01bc16593f7b
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Date deposited: 02 Aug 2017 16:31
Last modified: 16 Mar 2024 03:32
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Contributors
Author:
Jorge D. Ramos
Author:
Martin F. Casey
Author:
Aristotelis Bamias
Author:
Lauren C Harshman
Author:
Yu-Ning Wong
Author:
Joaquim Bellmunt
Author:
Ugo De Giorgi
Author:
Sylvain Ladoire
Author:
Thomas Powles
Author:
Sumanta K. Pal
Author:
Guenter Niegisch
Author:
Federica Recine
Author:
Ajjai Alva
Author:
Neeraj Agarwal
Author:
Andrea Necchi
Author:
Ulka N. Vaishampayan
Author:
Jonathan E. Rosenberg
Author:
Matthew D. Galsky
Author:
Evan Y. Yu
Corporate Author: RISC Investigators
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