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Journal of Clinical Oncology, 2004 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 22, No 14S (July 15 Supplement), 2004: 8218
© 2004 American Society of Clinical Oncology
Incidence of thrombosis in gastro-esophageal cancer; a cohort study of 761 patients
M. Tesselaar,
N. Steeghs,
F. Rosendaal and
S. Osanto
LUMC, Leiden, Netherlands
8218
Background: The incidence of venous thrombosis (VT) is increased in cancer patients compared to the general population. Patients with adenocarcinoma are believed to have the highest risk of developing VT, but limited data are available on the incidence of VT in different histological types of malignancy. To study the incidence of VT with an emphasis on the comparison between different histological types of cancer in the same organ site, we conducted a retrospective analysis in patients with upper gastro-intestinal cancer. Methods: Between 1980 and 2000, a total of 530 patients (213 adeno- and 317 squamous cell carcinoma) with esophageal cancer and between 1990 and 2000, 231 patients with gastric adenocarcinoma were included in the study. Patients and tumor characteristics were recorded from the medical records, whereas information about the VT was collected from medical records, oncology database and the regional anticoagulation clinics. All VT 1 year before, during or after the diagnosis of cancer were used for analysis. Results: Twenty-nine (5 %) of the 530 esophageal cancer patients and 23 (10 %) of the 231 gastric cancer patients developed VT. Five (10 %) of 52 VT occurred within 1 year before the diagnosis of cancer was made, 38 (73 %) coinciding with the time of diagnosis, whereas 9 (17 %) VT occurred after cancer was diagnosed (all 9 VT occurred at the time of recurrence of their cancer). The risk for VT in patients with adenocarcinoma was more than 2-fold increased as compared to those patients with a squamous cell carcinoma in all patients with upper gastro-intestinal tract cancer; i.e. 9.0 % respectively 3.8 % (OR= 2.51; 95% CI 1.30–4.88). In the patients with esophageal cancer the risk for VT was also 2-fold increased in adenocarcinoma as compared to squamous cell carcinoma; i.e. 3.8 % respectively 8.0 % (OR= 2.20; 95% CI 1.03–4.72). Conclusions: The risk of VT in patients with carcinoma arising in the upper gastro-intestinal tract is more than two-fold increased in adenocarcinoma as compared to squamous cell carcinoma. Our data on upper gastro-intestinal carcinoma confirm the notion that particular adenocarcinoma are associated with coagulopathy.
No significant financial relationships to disclose.
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