PDF(Pubmed)
Abstract：
BACKGROUND: Venous thromboembolism (VTE), a common complication in cancer patients, occurs more often during the initial phase of treatment. However, information on VTE beyond the first two years after diagnosis (\'late VTE\') is scarce, particularly in young survivors.
METHODS: We examined the risk of, and factors associated with, late VTE among adolescents and young adults (AYA, 15-39 years) diagnosed with cancer (2006-2018) who survived ≥2 years. Data were obtained from the California Cancer Registry linked to hospitalization, emergency department and ambulatory surgery data. We used non-parametric models and Cox proportional hazard regression for analyses.
RESULTS: Among 59,343 survivors, the 10-year cumulative incidence of VTE was 1.93 % (CI 1.80-2.07). The hazard of VTE was higher among those who had active cancer, including progression from lower stages to metastatic disease (Hazard Ratio (HR) = 10.41, 95 % confidence interval (CI): 8.86-12.22), second primary cancer (HR = 2.58, CI:2.01-3.31), or metastatic disease at diagnosis (HR = 2.38, CI:1.84-3.09). The hazard of late VTE was increased among survivors who underwent hematopoietic cell transplantation, those who received radiotherapy, had a VTE history, public insurance (vs private) or non-Hispanic Black/African American race/ethnicity (vs non-Hispanic White). Patients with leukemias, lymphomas, sarcoma, melanoma, colorectal, breast, and cervical cancers had a higher VTE risk than those with thyroid cancer.
CONCLUSIONS: VTE risk remained elevated ≥2 years following cancer diagnosis in AYA survivors. Active cancer is a significant risk factor for VTE. Future studies might determine if late VTE should prompt evaluation for recurrence or second malignancy, if not already known.
METHODS: We examined the risk of, and factors associated with, late VTE among adolescents and young adults (AYA, 15-39 years) diagnosed with cancer (2006-2018) who survived ≥2 years. Data were obtained from the California Cancer Registry linked to hospitalization, emergency department and ambulatory surgery data. We used non-parametric models and Cox proportional hazard regression for analyses.
RESULTS: Among 59,343 survivors, the 10-year cumulative incidence of VTE was 1.93 % (CI 1.80-2.07). The hazard of VTE was higher among those who had active cancer, including progression from lower stages to metastatic disease (Hazard Ratio (HR) = 10.41, 95 % confidence interval (CI): 8.86-12.22), second primary cancer (HR = 2.58, CI:2.01-3.31), or metastatic disease at diagnosis (HR = 2.38, CI:1.84-3.09). The hazard of late VTE was increased among survivors who underwent hematopoietic cell transplantation, those who received radiotherapy, had a VTE history, public insurance (vs private) or non-Hispanic Black/African American race/ethnicity (vs non-Hispanic White). Patients with leukemias, lymphomas, sarcoma, melanoma, colorectal, breast, and cervical cancers had a higher VTE risk than those with thyroid cancer.
CONCLUSIONS: VTE risk remained elevated ≥2 years following cancer diagnosis in AYA survivors. Active cancer is a significant risk factor for VTE. Future studies might determine if late VTE should prompt evaluation for recurrence or second malignancy, if not already known.
摘要：
背景：静脉血栓栓塞症（VTE），癌症患者的常见并发症，更经常发生在治疗的初始阶段。然而,诊断后的前两年（“晚期VTE”）的VTE信息很少，尤其是年轻的幸存者。
方法：我们检查了以下风险：以及与之相关的因素，青少年和年轻人的晚期VTE(AYA，15-39岁）诊断为癌症（2006-2018），存活≥2年。数据来自加州癌症登记处与住院相关，急诊科和门诊手术数据。我们使用非参数模型和Cox比例风险回归进行分析。
结果：在59,343名幸存者中，VTE的10年累积发病率为1.93%(CI1.80~2.07).在患有活动性癌症的人群中，VTE的风险更高，包括从低分期到转移性疾病的进展（危险比（HR）=10.41，95％置信区间（CI）：8.86-12.22），第二原发癌（HR=2.58，CI：2.01-3.31），或诊断时的转移性疾病（HR=2.38，CI：1.84-3.09）。在接受造血细胞移植的幸存者中，晚期VTE的危险增加。那些接受放射治疗的人，有VTE历史，公共保险（vs私人）或非西班牙裔黑人/非裔美国人种族/种族（vs非西班牙裔白人）。白血病患者,淋巴瘤,肉瘤,黑色素瘤，结直肠,乳房,宫颈癌的VTE风险高于甲状腺癌患者.
结论：AYA幸存者在癌症诊断后≥2年VTE风险仍然升高。活动性癌症是VTE的重要风险因素。未来的研究可能会确定晚期VTE是否应提示复发或第二恶性肿瘤的评估。如果还不知道。
方法：我们检查了以下风险：以及与之相关的因素，青少年和年轻人的晚期VTE(AYA，15-39岁）诊断为癌症（2006-2018），存活≥2年。数据来自加州癌症登记处与住院相关，急诊科和门诊手术数据。我们使用非参数模型和Cox比例风险回归进行分析。
结果：在59,343名幸存者中，VTE的10年累积发病率为1.93%(CI1.80~2.07).在患有活动性癌症的人群中，VTE的风险更高，包括从低分期到转移性疾病的进展（危险比（HR）=10.41，95％置信区间（CI）：8.86-12.22），第二原发癌（HR=2.58，CI：2.01-3.31），或诊断时的转移性疾病（HR=2.38，CI：1.84-3.09）。在接受造血细胞移植的幸存者中，晚期VTE的危险增加。那些接受放射治疗的人，有VTE历史，公共保险（vs私人）或非西班牙裔黑人/非裔美国人种族/种族（vs非西班牙裔白人）。白血病患者,淋巴瘤,肉瘤,黑色素瘤，结直肠,乳房,宫颈癌的VTE风险高于甲状腺癌患者.
结论：AYA幸存者在癌症诊断后≥2年VTE风险仍然升高。活动性癌症是VTE的重要风险因素。未来的研究可能会确定晚期VTE是否应提示复发或第二恶性肿瘤的评估。如果还不知道。
