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Cancer-Associated Venous Thromboembolism in Ambulatory Solid Organ Malignancy Patients: Experience from a Cancer Research Institute

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Abstract

Cancer-associated deep venous thrombosis (DVT) and venous thromboembolism (VTE) are exceedingly common in patients with cancer. One-fifth of DVT events occur in patients with cancer and it is the second leading cause of death in patients with cancer after cancer itself. Data on DVT in cancer patients on medical therapy, especially from Indian experiences, are sparse. Here, we present our experience in ambulatory patients with solid organ cancer. The purpose of the study was to study the incidence of DVT in cancer patients on medical therapy and to analyze probable DVT risk factors. This study was a hospital-based single-arm retrospective collection and analysis of hospital records from patients receiving medical therapy on an outpatient and short-stay basis. From January 2016 to February 2017, adult solid organ cancer patients attending the medical oncology outpatient department (OPD), receiving active anticancer treatment, either oral or injectable, were included. The data was retrieved from the medical records department and the department of radiology. Descriptive statistics were used to analyze the data. Twenty-nine out of 1190 patients were documented to have developed DVT during the study period. The incidence of DVT in the outpatient settings was 2.4%, and DVT associated with venous access device in situ was seen in 4.05% (20/493) of the patients. Gynecological, breast, and hepatobiliary malignancies comprised most of the cases. Cancer patients are clearly at increased risk for DVT, but this risk is highly variable. It differs between subgroups of cancer patients. Five points Khorana risk model can predict risk for DVT in the ambulatory cancer patients receiving chemotherapy; however, the routine use of thromboprophylaxis in all cancer patients is not recommended. High-risk patients especially those with venous access devices need careful evaluation and counseling for prompt reporting and recognition of venous thrombosis.

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Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Medical Oncology, Hematology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

    Amit Sehrawat & Deepak Sundriyal

  2. Department of Surgery, Santosh Medical College & Hospital, Ghaziabad, Uttar Pradesh, India

    Gyanendra Swaroop Mittal

  3. Department of Medical Oncology, SMS Medical College, Jaipur, India

    Anushree Chaturvedi

  4. Department of Medical Oncology, Dharamshila Narayana Superspeciality Hospital, New Delhi, India

    Deni Gupta

Authors
  1. Amit Sehrawat
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  2. Gyanendra Swaroop Mittal
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  3. Deepak Sundriyal
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  4. Anushree Chaturvedi
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  5. Deni Gupta
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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by AS, AC, and DG. The manuscript was written by DS, AS, GSM, and AC. Manuscript review and editing was done by AS, DG, and DS. All authors read and approved the final manuscript.

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Correspondence to Deepak Sundriyal.

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Not applicable for record based retrospective studies and waived off.

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The authors declare no conflict of interest.

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Sehrawat, A., Mittal, G.S., Sundriyal, D. et al. Cancer-Associated Venous Thromboembolism in Ambulatory Solid Organ Malignancy Patients: Experience from a Cancer Research Institute. Indian J Surg Oncol 12, 246–250 (2021). https://doi.org/10.1007/s13193-021-01303-x

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  • DOI: https://doi.org/10.1007/s13193-021-01303-x

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