■血栓栓塞是癌症患者的重要并发症,导致治疗中断和不良结果。
■这项研究的目的是调查癌症人群中动脉血栓栓塞(ATE)的发生率,确定ATE的预测因子,并确定其生存影响。
■使用大阪癌症登记处的数据与2010年至2015年的管理数据进行了回顾性多中心研究。癌症诊断后对患者进行了5年的监测,并且以死亡为竞争风险计算ATE发生率。使用精细和灰色竞争风险回归模型和Cox比例风险模型来评估ATE的预测因子和生存影响。限制性平均生存时间(RMST)用于评估ATE后抗血栓治疗是否有助于提高生存率。
■该队列包括97,448名癌症患者(42.3%的女性,中位年龄70岁)。ATE发病率呈逐年上升趋势,癌症诊断后1年达到峰值(1-,2-,3-,4-,5年累计发病率为1.29%,1.77%,2.05%,2.22%,和2.32%,分别)。男性,高龄,晚期癌症阶段,和血液系统恶性肿瘤与ATE的高风险相关。与没有ATE的患者相比,有ATE的患者死亡风险增加2倍。抗血栓治疗患者的90天和1年RMST差异为13.3天(95%CI:10.4-16.2天;P<0.001)和57.8天(95%CI:43.1-72.5天;P<0.001),支持抗血栓治疗组。RMST差异因癌症分期而异。
■ATE的风险因性别而异,年龄,和癌症进展和类型。ATE后抗血栓治疗与癌症患者生存率改善相关
UNASSIGNED: Thromboembolism is a significant complication for patients with cancer, leading to treatment interruptions and poor outcomes.
UNASSIGNED: The aim of this study was to investigate the incidence of arterial thromboembolism (ATE) within cancer populations, identify the predictors of ATE, and determine its survival impact.
UNASSIGNED: A retrospective multicenter study was performed using data from the Osaka Cancer Registry linked with administrative data from 2010 to 2015. Patients were monitored for 5 years after cancer diagnosis, and ATE incidence was calculated with death as a competing risk. Fine and Gray competing risk regression models and Cox proportional hazards models were used to evaluate the predictors of ATE and the survival impact. Restricted mean survival time (RMST) was used to assess whether antithrombotic therapy after ATE contributed to improved survival.
UNASSIGNED: The cohort comprised 97,448 patients with cancer (42.3% women, median age 70 years). ATE incidence displayed an annual increase, peaking 1 year after cancer diagnosis (1-, 2-, 3-, 4-, and 5-year cumulative incidences were 1.29%, 1.77%, 2.05%, 2.22%, and 2.32%, respectively). Male sex, advanced age, advanced cancer stage, and hematologic malignancies correlated with a high risk for ATE. Patients with ATE had a 2-fold increased risk for mortality compared with those without ATE. The 90-day and 1-year RMST differences for those on antithrombotic therapy were 13.3 days (95% CI: 10.4-16.2 days; P < 0.001) and 57.8 days (95% CI: 43.1-72.5 days; P < 0.001), favoring the antithrombotic therapy group. The RMST differences varied by cancer stage.
UNASSIGNED: The risk for ATE varies according to sex, age, and cancer progression and type. Antithrombotic therapy after ATE is associated with improved survival among patients with cancer.