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Development of a predictive model for 6 month survival in patients with venous thromboembolism and solid malignancy requiring IVC filter placement

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Abstract

Purpose: Our purpose was to develop a predictive model for short-term survival (i.e. <6 months) following inferior vena cava filter placement in patients with venous thromboembolism (VTE) and solid malignancy. Methods: Clinical and laboratory parameters were retrospectively reviewed for patients with solid malignancy who received a filter between January 2009 and December 2011 at a tertiary care cancer center. Multivariate Cox proportional hazards modeling was used to assess variables associated with 6 month survival following filter placement in patients with VTE and solid malignancy. Significant variables were used to generate a predictive model. Results: 397 patients with solid malignancy received a filter during the study period. Three variables were associated with 6 month survival: (1) serum albumin [hazard ratio (HR) 0.496, P < 0.0001], (2) recent or planned surgery (<30 days) (HR 0.409, P < 0.0001), (3) TNM staging (stage 1 or 2 vs. stage 4, HR 0.177, P = 0.0001; stage 3 vs. stage 4, HR 0.367, P = 0.0002). These variables were used to develop a predictive model to estimate 6 month survival with an area under the receiver operating characteristic curve of 0.815, sensitivity of 0.782, and specificity of 0.715. Conclusions: Six month survival in patients with VTE and solid malignancy requiring filter placement can be predicted from three patient variables. Our predictive model could be used to help physicians decide whether a permanent or retrievable filter may be more appropriate as well as to assess the risks and benefits for filter retrieval within the context of survival longevity in patients with cancer.

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Authors and Affiliations

  1. Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA

    Steven Y. Huang, Bruno C. Odisio, Sharjeel H. Sabir & Sanjay Gupta

  2. The Methodist Hospital Cancer Center, Methodist Hospital Research Institute, 6670 Bertner Avenue, Houston, TX, 77030, USA

    Joe E. Ensor

  3. The University of Texas Health Science Center at Houston, 7000 Fannin Suite 1200, Houston, TX, 77030, USA

    Andrew S. Niekamp

  4. Department of Vascular Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA

    Tam T. Huynh

  5. Department of Benign Hematology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA

    Michael Kroll

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  1. Steven Y. Huang
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Correspondence to Steven Y. Huang.

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Conflict of interest

Steven Y. Huang, Scientific Board Member, Adient Medical Inc. Sharjeel H. Sabir, Consulting fees, Cook Medical; Educational travel grants from Boston Scientific, Terumo, Neuwave Medical, Merit Medical.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Approval for this retrospective review study was obtained from our institutional review board. The requirement for informed consent was waived by the institutional review board.

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Huang, S.Y., Odisio, B.C., Sabir, S.H. et al. Development of a predictive model for 6 month survival in patients with venous thromboembolism and solid malignancy requiring IVC filter placement. J Thromb Thrombolysis 44, 30–37 (2017). https://doi.org/10.1007/s11239-017-1493-1

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  • DOI: https://doi.org/10.1007/s11239-017-1493-1

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