Predicting recurrences or major bleeding in women with cancer and venous thromboembolism. Findings from the RIETE Registry.
BACKGROUND
Cancer patients with venous thromboembolism (VTE) have an increased incidence of recurrences and bleeding complications Reliable information on the factors determining the risk for such complications may facilitate better use of therapy.


METHODS
RIETE Registry is an ongoing, international registry of consecutive patients presenting with symptomatic acute VTE confirmed by objective tests. We assessed the 3-month outcome in all women with active cancer, trying to identify if differences exist according to the tumor site.


RESULTS
Up to May 2007, 18,883 patients had been enrolled. Of them, 3805 (20%) had active cancer, 1719 (45%) were women. During the 3-month study period, 40 (2.3%) had recurrent deep vein thrombosis, 39 (2.3%) recurrent pulmonary embolism (PE), 67 (3.9%) major bleeding, 394 (23%) died. Of these, 13 (33%) women with recurrent PE died of the PE, 17 (42%) with major bleeding had fatal bleeding. In women with gastrointestinal (5.7% vs. 4.3%) or genitourinary (6.4% vs. 4.7%) cancers the incidence of bleeding complications exceeded that of VTE recurrences, while in those with brain (3.4% vs. 13%) or lung cancer (2.6% vs. 11%) the rate of recurrences outweighed that of major bleeding.


CONCLUSIONS
We identified significant differences in outcome according to the site of cancer that may help to identify those women with cancer and VTE at a higher risk for recurrences or major bleeding.
Trujillo-Santos
Javier
J
Department of Internal Medicine, Hospital Universitario Santa María de Rosell, Cartagena, Murcia.
Ruiz-Gamietea
Angeles
A
Luque
Juan Manuel
JM
Samperiz
Angel Luis
AL
Garcia-Bragado
Ferrán
F
Todoli
José Antonio
JA
Monreal
Manuel
M
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D009369:Neoplasms / Q000097:blood* / Q000628:therapy; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis; D012042:Registries; D012307:Risk Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis
D000925:Anticoagulants