Background: The role of residual venous thrombosis (RVT) as a risk factor for recurrent venous thromboembolism (VTE) in patients with cancer-associated thrombosis (CAT) remains controversial.Methods: We conducted a cohort study on consecutive patients with CAT treated with tinzaparin recruited between 2007 and 2022. Primary outcome: RVT. Secondary outcomes: identification of variables associated with RVT and the role of RVT in VTE recurrences or clinically relevant bleeding (CRB).Results: Among 511 patients with CAT (age 64.1 years ± 13.4 years; 53.5% males) followed for 17.6 months (p25–75: 7.9–34), 35.8% (n = 183) presented RVT (at 6 months, 55.5%). Variables identified as being associated with RVT were ECOG performance status > 1, metastasis, and cancer location. Within 5 years, there were 57 CRB (11.2%; 95% CI: 8.6–14.2) and 67 VTE recurrences (13.1%, 95%CI: 10.3–16.4). Competing risk analysis identified that RVT at 6 months was associated with VTE recurrence within 5 years (sub-hazard ratio: 2.1; 95% CI: 1.2–3.7;p= 0.006), but not with CRB. Multivariate analysis confirmed that RVT at 6 months (HR: 2.1; 95% CI: 1.2–3.7) and metastases (HR: 1.7; 95% CI: 1.1–2.9) were associated with VTE recurrence within 5 years.Conclusions: RVT is high in patients with CAT. The presence of RVT at 6 months was associated with an increased risk of recurrent VTE over 5 years.
背景：在癌症相关血栓形成（CAT）患者中，残余静脉血栓（RVT）作为复发性静脉血栓栓塞（VTE）风险因素的作用仍存在争议。 方法：我们对2007年至2022年间连续招募的使用亭扎肝素治疗的CAT患者进行了一项队列研究。主要结局指标为RVT。次要结局指标包括识别与RVT相关的变量，以及RVT在VTE复发或临床相关出血（CRB）中的作用。 结果：在511例CAT患者（年龄64.1岁±13.4岁；男性占53.5%）中，中位随访时间为17.6个月（四分位距：7.9–34个月），35.8%（n = 183）的患者出现RVT（6个月时RVT发生率为55.5%）。与RVT相关的变量包括ECOG体能状态评分>1、存在转移及癌症部位。在5年随访期内，共发生57例CRB（11.2%；95% CI：8.6–14.2）和67例VTE复发（13.1%，95% CI：10.3–16.4）。竞争风险分析显示，6个月时的RVT与5年内VTE复发相关（次风险比：2.1；95% CI：1.2–3.7；p=0.006），但与CRB无关。多变量分析证实，6个月时的RVT（风险比：2.1；95% CI：1.2–3.7）和转移（风险比：1.7；95% CI：1.1–2.9）与5年内VTE复发相关。 结论：CAT患者的RVT发生率较高。6个月时存在RVT与5年内VTE复发风险增加相关。
肿瘤(癌症)患者之家