title: OC-15 - Risk factors for cancer development after idiopathic venous thromboembolism.
abstract: BACKGROUND
  Idiopathic venous thromboembolism (VTE) is associated with the risk of cancer but the risk factors for cancer development in such patients are still uncertain.
  
  
  OBJECTIVE
  To assess risk factors for the development of cancer after a standard course of anticoagulation in patients with first episode of idiopathic VTE.
  
  
  METHODS
  Subjects were enrolled in the three large prospective multicentre studies: PROLONG (NEJM 2006) PROLONG II (Blood 2010) and DULCIS (Blood 2014). Women whose index event was hormone related were excluded from the analysis. The development of cancer was recorded during a 2-year follow-up.
  
  
  RESULTS
  1,805 patients were enrolled (M/F: 510/453), mean age: 62, median: 67; range:18-87 years). Cancer developed in 55 patients (3% ; 1.7% pt-years) of whom 15 (2.0%; 1.1% pt-years) had PE with or without DVT and 40 (3.8%; 2.1% pt-years) had DVT without PE (p=0.03). The development of cancer was associated with DVT without PE (HR:1.8; 95% CI: 1.1-3.3) and age >65 (HR: 2.5; 95%: 1.3-4.9). Among patients with DVT, with or without PE, the development of cancer was associated with the presence of residual vein obstruction>4mm (RVO) at compression ultrasound (HR: 1.8, 95% CI: 1.1-3.3) and age>65 (HR: 2.8; 95% CI: 1.3-6.2).
  
  
  CONCLUSIONS
  Age>65 years, DVT without PE and the presence of RVO are significantly associated with the risk of developing cancer after a first episode of idiopathic VTE over a two-year follow-up.
authors.affiliation: Dept. Angiology & Blood Coagulation, University Hospital S. Orsola-Malpighi, Bologna.
authors.forename: B
authors.initials: B
authors.lastname: Cosmi
authors.affiliation: Dept. Angiology & Blood Coagulation, University Hospital S. Orsola-Malpighi, Bologna.
authors.forename: C
authors.initials: C
authors.lastname: Legnani
authors.affiliation: Dept. Internal Medicine I, Angiology, Arcispedale Santa Maria Nuova, Reggio Emilia.
authors.forename: A
authors.initials: A
authors.lastname: Ghirarduzzi
authors.affiliation: Haemostasis and Thrombosis Centre, Hospital of Lecco.
authors.forename: V
authors.initials: V
authors.lastname: De Micheli
authors.affiliation: Dept. of Cardiothoracic and Vascular Sciences, University Hospital of Padua.
authors.forename: V
authors.initials: V
authors.lastname: Pengo
authors.affiliation: Haemostasis & Thrombosis Center, General Hospital, Cremona.
authors.forename: S
authors.initials: S
authors.lastname: Testa
authors.affiliation: Thrombosis Centre, Dept. Heart and Vessels, University Hospital of Florence.
authors.forename: D
authors.initials: D
authors.lastname: Poli
authors.affiliation: Thrombosis Centre, Dept. Heart and Vessels, University Hospital of Florence.
authors.forename: E
authors.initials: E
authors.lastname: Antonucci
authors.affiliation: Thrombosis Centre, Dept. Heart and Vessels, University Hospital of Florence.
authors.forename: D
authors.initials: D
authors.lastname: Prisco
authors.affiliation: Angelo Bianchi Bonomi Hemophilia & Thrombosis Center, Dept. Internal Medicine, University & IRCCS Maggiore Hospital, Milan.
authors.forename: A
authors.initials: A
authors.lastname: Tripodi
authors.affiliation: Internal Medicine, Dept. of Medical and Surgical Sciences, University Hospital of Padua; Italy.
authors.forename: P
authors.initials: P
authors.lastname: Prandoni
authors.affiliation: Dept. Angiology & Blood Coagulation, University Hospital S. Orsola-Malpighi, Bologna.
authors.forename: G
authors.initials: G
authors.lastname: Palareti