title: The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site.
abstract: BACKGROUND
  We hypothesized that the clinical course of venous thromboembolism in patients with active cancer may differ according to the specificities of primary tumor site.
  
  
  OBJECTIVE
  We used data from RIETE (international registry of patients with venous thromboembolism) to compare the clinical venous thromboembolism-related outcomes during the course of anticoagulation in patients with one of the 4 more frequent cancers (breast, prostate, colorectal, or lung cancer).
  
  
  RESULTS
  As of September 2014, 3947 cancer patients were recruited, of whom 938 had breast, 629 prostate, 1189 colorectal, and 1191 lung cancer. Overall, 55% had metastatic disease (42%, 36%, 53%, and 72%, respectively). During the course of anticoagulant therapy (mean duration, 139 days), the rate of thromboembolic recurrences was similar to the rate of major bleeding in patients with breast (5.6 [95% confidence interval (CI), 3.8-8.1] vs 4.1 [95% CI, 2.7-5.9] events per 100 patient-years) or colorectal cancer (10 [95% CI, 7.6-13] vs 12 [95% CI, 9.4-15] per 100 patient-years). In contrast, in patients with prostate cancer, the rate of venous thromboembolic recurrences was half the rate of major bleeding (6.9 [95% CI, 4.4-10] vs 13 [95% CI, 9.2-17] events per 100 patient-years), whereas in those with lung cancer, the rate of thromboembolic recurrences was twofold higher than the rate of major bleeding (27 [95% CI, 22-23] vs 11 [95% CI, 8.6-15] per 100 patient-years).
  
  
  CONCLUSIONS
  Significant differences in the clinical profile of venous thromboembolic-related outcomes were observed according to the site of cancer. These findings suggest the development of cancer-specific anticoagulant strategies as an area for further research.
authors.affiliation: Department of Internal Medicine, Hôpital Louis Mourier, Investigation Network on Venous Thrombo-embolism (INNOVTE), Colombes (APHP), University Paris 7, EA REMES 7334 France. Electronic address: isabelle.mahe@aphp.fr.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Mahé
authors.affiliation: Department of Internal Medicine, Hôpital Louis Mourier, Investigation Network on Venous Thrombo-embolism (INNOVTE), Colombes (APHP), University Paris 7, EA REMES 7334 France.
authors.forename: Jean
authors.initials: J
authors.lastname: Chidiac
authors.affiliation: Department of Vascular and Therapeutic Medicine, CHU Saint-Etienne, Hôpital Nord, French Clinical Research Infrastructure Network (F-CRIN), INNOVTE.
authors.forename: Laurent
authors.initials: L
authors.lastname: Bertoletti
authors.affiliation: Department of Medical Oncology, IDIBAPS/Translational Genomics and Targeted Therapeutics in Solid Tumors, Hospital Clinic de Barcelona, Spain.
authors.forename: Carme
authors.initials: C
authors.lastname: Font
authors.affiliation: Department of Internal Medicine, Complejo Hospitalario Universitario de Cartagena, Murcia, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Trujillo-Santos
authors.affiliation: Department of Internal Medicine, Hospital Provincial Castellon; CEU Cardenal Herrero University, Spain.
authors.forename: Marisa
authors.initials: M
authors.lastname: Peris
authors.affiliation: Department of Emergency Medicine, Hospital Universitario Doctor Peset, Valencia, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Pérez Ductor
authors.affiliation: Department of Haematology, Hospital de la Vega Lorenzo Guirao, Murcia, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Nieto
authors.affiliation: Atherosclerosis and Thrombosis Unit, Casa Sollievo Della Sofferenza, Foggia, Italy.
authors.forename: Elvira
authors.initials: E
authors.lastname: Grandone
authors.affiliation: Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Universidad Católica de Murcia, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Monreal
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000150:complications / Q000473:pathology; D015179:Colorectal Neoplasms / Q000150:complications / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D011471:Prostatic Neoplasms / Q000150:complications / Q000473:pathology; D012008:Recurrence; D012042:Registries; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000209:etiology* / Q000473:pathology / Q000628:therapy
chemical_list: D000925:Anticoagulants
keywords: Anticoagulant therapy; Bleeding; Cancer; Mortality; Recurrences; Venous thromboembolism