The risk of venous thrombosis is higher in cancer patients. But we do not know if there are specific features for the venous thrombosis in cancer patients. We believe that the thrombosis is dependent on the circulating procoagulant factors associated with or released by the cancer tissues. Is the proximal deep vein thrombosis (iliac vein) more common in cancer patients?
In a study conducted on - For 3263 patients with cancer, the venous thrombosis incidence was: total 31.4% (n=1026), proximal 14.5% (n=472), bilateral 8.5% (n=278) and multiple venous sites 4.6% (n=149). The rate of clinical suspicion of pulmonary embolism was 49.9% (n=1628). For 1026 patients withthrombosis, proximal thrombi were nearly as frequent as distal thrombi, with 17.6% (n=181) iliocaval thrombi. Gastrocnemial, popliteal and femoral veins were almost equally concerned by thrombosis with respective rates of 28.7% (n=278), 27.1% (n=294) and 25.6% (n=263). Superficial veins were concerned in 23.5% (n=241). Partial or floating clots occurred frequently in 4 localizations: common femoral, external iliac, femoral and popliteal veins. J Mal Vasc. 2013 Jun 18. pii: S0398-0499(13)00131-5. doi: 10.1016/j.jmv.2013.05.001. [Epub ahead of print]
This results of this study point out that - Proximal, multiple, partial, mobile thrombi, and such unusual locations as gastrocnemial or superficial thromboses, are potentially indicators for selecting patients that may benefit from a cancer check-up because their venous thrombosis could be due to cancer.
It may not be cost effective to screen all patients for cancer in our clinical practice - in addition to the above factors related to venous thrombosis, we should remember that recurrence of DVT requiring admissions ( 2 or 3 times) in last 6 months should also prompt us to think and investigate for the cryptogenic malignancies. We found this very useful in our clinical practice not to miss the hidden malignancies.
30th June 2013
In a study conducted on - For 3263 patients with cancer, the venous thrombosis incidence was: total 31.4% (n=1026), proximal 14.5% (n=472), bilateral 8.5% (n=278) and multiple venous sites 4.6% (n=149). The rate of clinical suspicion of pulmonary embolism was 49.9% (n=1628). For 1026 patients withthrombosis, proximal thrombi were nearly as frequent as distal thrombi, with 17.6% (n=181) iliocaval thrombi. Gastrocnemial, popliteal and femoral veins were almost equally concerned by thrombosis with respective rates of 28.7% (n=278), 27.1% (n=294) and 25.6% (n=263). Superficial veins were concerned in 23.5% (n=241). Partial or floating clots occurred frequently in 4 localizations: common femoral, external iliac, femoral and popliteal veins. J Mal Vasc. 2013 Jun 18. pii: S0398-0499(13)00131-5. doi: 10.1016/j.jmv.2013.05.001. [Epub ahead of print]
This results of this study point out that - Proximal, multiple, partial, mobile thrombi, and such unusual locations as gastrocnemial or superficial thromboses, are potentially indicators for selecting patients that may benefit from a cancer check-up because their venous thrombosis could be due to cancer.
It may not be cost effective to screen all patients for cancer in our clinical practice - in addition to the above factors related to venous thrombosis, we should remember that recurrence of DVT requiring admissions ( 2 or 3 times) in last 6 months should also prompt us to think and investigate for the cryptogenic malignancies. We found this very useful in our clinical practice not to miss the hidden malignancies.
30th June 2013
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