Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Cancer-Associated Venous Thromboembolism in the Real World ― From the COMMAND VTE Registry ―
Jiro SakamotoYugo YamashitaTakeshi MorimotoHidewo AmanoToru TakaseSeiichi HiramoriKitae KimMaki OiMasaharu AkaoYohei KobayashiMamoru ToyofukuToshiaki IzumiTomohisa TadaPo-Min ChenKoichiro MurataYoshiaki TsuyukiSyunsuke SagaYuji NishimotoTomoki SasaMinako KinoshitaKiyonori TogiHiroshi MabuchiKensuke TakabayashiYusuke YoshikawaHiroki ShiomiTakao KatoTakeru MakiyamaKoh OnoToshihiro TamuraYoshihisa NakagawaTakeshi Kimuraon behalf of the COMMAND VTE Registry Investigators
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論文ID: CJ-19-0515

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Background:There is a paucity of data on the management and prognosis of cancer-associated venous thromboembolism (VTE), leading to uncertainty about optimal management strategies.

Methods and Results:The COMMAND VTE Registry is a multicenter registry enrolling 3,027 consecutive acute symptomatic VTE patients in Japan between 2010 and 2014. We divided the entire cohort into 3 groups: active cancer (n=695, 23%), history of cancer (n=243, 8%), and no history of cancer (n=2089, 69%). The rate of anticoagulation discontinuation was higher in patients with active cancer (43.5%, 27.0%, and 27.0%, respectively, at 1 year, P<0.001). The cumulative 5-year incidences of recurrent VTE, major bleeding, and all-cause death were higher in patients with active cancer (recurrent VTE: 17.7%, 10.2%, and 8.6%, P<0.001; major bleeding: 26.6%, 8.8%, and 9.3%, P<0.001; all-cause death: 73.1%, 28.6%, 14.6%, P<0.001). Among the 4 groups classified according to active cancer status, the cumulative 1-year incidence of recurrent VTE was higher in the metastasis group (terminal stage group: 6.4%, metastasis group: 22.1%, under chemotherapy group: 10.8%, and other group: 5.8%, P<0.001).

Conclusions:In a current real-world VTE registry, patients with active cancer had higher risk for VTE recurrence, bleeding, and death, with variations according to cancer status, than patients without active cancer. Anticoagulation therapy was frequently discontinued prematurely in patients with active cancer in discordance with current guideline recommendations.

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© 2019 THE JAPANESE CIRCULATION SOCIETY
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