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,...

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Detalhes bibliográficos
Autores: Ramos, Jorge D., Bellmunt Molins, Joaquim, 1959-, Yu, Evan Y.
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Recursos:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/33426
Acesso em linha:http://hdl.handle.net/10230/33426
http://dx.doi.org/10.1002/cam4.986
Access Level:acceso abierto
Palavra-chave:Venous thromboembolism
Bufeta -- Càncer
Trombosi -- Tractament
Urothelial
Bladder cancer
Chemotherapy survival
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spelling Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survivalRamos, Jorge D.Bellmunt Molins, Joaquim, 1959-Yu, Evan Y.Venous thromboembolismBufeta -- CàncerTrombosi -- TractamentUrothelialBladder cancerChemotherapy survivalVenous thromboembolismVenous 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.Wiley201720172017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/33426http://dx.doi.org/10.1002/cam4.986reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésCancer Medicine. 2017 Jan;6(1):186-94Cancer Medicine. 2017 Jan;6(1):186-94TThis is an open access article under the terms of https://creativecommons.org/licenses/by/4.0/, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/334262026-06-12T07:21:37Z
dc.title.none.fl_str_mv Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival
title Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival
spellingShingle Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival
Ramos, Jorge D.
Venous thromboembolism
Bufeta -- Càncer
Trombosi -- Tractament
Urothelial
Bladder cancer
Chemotherapy survival
Venous thromboembolism
title_short Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival
title_full Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival
title_fullStr Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival
title_full_unstemmed Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival
title_sort Venous thromboembolism in metastatic urothelial carcinoma or variant histologies: incidence, associative factors, and effect on survival
dc.creator.none.fl_str_mv Ramos, Jorge D.
Bellmunt Molins, Joaquim, 1959-
Yu, Evan Y.
author Ramos, Jorge D.
author_facet Ramos, Jorge D.
Bellmunt Molins, Joaquim, 1959-
Yu, Evan Y.
author_role author
author2 Bellmunt Molins, Joaquim, 1959-
Yu, Evan Y.
author2_role author
author
dc.subject.none.fl_str_mv Venous thromboembolism
Bufeta -- Càncer
Trombosi -- Tractament
Urothelial

Bladder cancer
Chemotherapy survival
Venous thromboembolism
topic Venous thromboembolism
Bufeta -- Càncer
Trombosi -- Tractament
Urothelial
Bladder cancer
Chemotherapy survival
Venous thromboembolism
description 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.
publishDate 2017
dc.date.none.fl_str_mv 2017
2017
2017
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/33426
http://dx.doi.org/10.1002/cam4.986
url http://hdl.handle.net/10230/33426
http://dx.doi.org/10.1002/cam4.986
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Cancer Medicine. 2017 Jan;6(1):186-94
Cancer Medicine. 2017 Jan;6(1):186-94
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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