Risk of venous thromboembolism in patients with cancer: a systematic review and meta-analysis.

<h4>Background</h4>People with cancer are known to be at increased risk of venous thromboembolism (VTE), and this risk is believed to vary according to cancer type, stage of disease, and treatment modality. Our purpose was to summarise the existing literature to determine precisely and a...

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Autores principales:	Freesia Horsted, Joe West, Matthew J Grainge
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/6f1700ee05e04fda8f07f9eaa42e173a
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spelling	oai:doaj.org-article:6f1700ee05e04fda8f07f9eaa42e173a2021-11-18T05:42:09ZRisk of venous thromboembolism in patients with cancer: a systematic review and meta-analysis.1549-12771549-167610.1371/journal.pmed.1001275https://doaj.org/article/6f1700ee05e04fda8f07f9eaa42e173a2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22859911/?tool=EBIhttps://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>People with cancer are known to be at increased risk of venous thromboembolism (VTE), and this risk is believed to vary according to cancer type, stage of disease, and treatment modality. Our purpose was to summarise the existing literature to determine precisely and accurately the absolute risk of VTE in cancer patients, stratified by malignancy site and background risk of VTE.<h4>Methods and findings</h4>We searched the Medline and Embase databases from 1 January 1966 to 14 July 2011 to identify cohort studies comprising people diagnosed with one of eight specified cancer types or where participants were judged to be representative of all people with cancer. For each included study, the number of patients who developed clinically apparent VTE, and the total person-years of follow-up were extracted. Incidence rates of VTE were pooled across studies using the generic inverse variance method. In total, data from 38 individual studies were included. Among average-risk patients, the overall risk of VTE was estimated to be 13 per 1,000 person-years (95% CI, 7 to 23), with the highest risk among patients with cancers of the pancreas, brain, and lung. Among patients judged to be at high risk (due to metastatic disease or receipt of high-risk treatments), the risk of VTE was 68 per 1,000 person-years (95% CI, 48 to 96), with the highest risk among patients with brain cancer (200 per 1,000 person-years; 95% CI, 162 to 247). Our results need to be considered in light of high levels of heterogeneity, which exist due to differences in study population, outcome definition, and average duration of follow-up between studies.<h4>Conclusions</h4>VTE occurs in greater than 1% of cancer patients each year, but this varies widely by cancer type and time since diagnosis. The absolute VTE risks obtained from this review can aid in clinical decision-making about which people with cancer should receive anticoagulant prophylaxis and at what times.Freesia HorstedJoe WestMatthew J GraingePublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 9, Iss 7, p e1001275 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Freesia Horsted Joe West Matthew J Grainge Risk of venous thromboembolism in patients with cancer: a systematic review and meta-analysis.
description	<h4>Background</h4>People with cancer are known to be at increased risk of venous thromboembolism (VTE), and this risk is believed to vary according to cancer type, stage of disease, and treatment modality. Our purpose was to summarise the existing literature to determine precisely and accurately the absolute risk of VTE in cancer patients, stratified by malignancy site and background risk of VTE.<h4>Methods and findings</h4>We searched the Medline and Embase databases from 1 January 1966 to 14 July 2011 to identify cohort studies comprising people diagnosed with one of eight specified cancer types or where participants were judged to be representative of all people with cancer. For each included study, the number of patients who developed clinically apparent VTE, and the total person-years of follow-up were extracted. Incidence rates of VTE were pooled across studies using the generic inverse variance method. In total, data from 38 individual studies were included. Among average-risk patients, the overall risk of VTE was estimated to be 13 per 1,000 person-years (95% CI, 7 to 23), with the highest risk among patients with cancers of the pancreas, brain, and lung. Among patients judged to be at high risk (due to metastatic disease or receipt of high-risk treatments), the risk of VTE was 68 per 1,000 person-years (95% CI, 48 to 96), with the highest risk among patients with brain cancer (200 per 1,000 person-years; 95% CI, 162 to 247). Our results need to be considered in light of high levels of heterogeneity, which exist due to differences in study population, outcome definition, and average duration of follow-up between studies.<h4>Conclusions</h4>VTE occurs in greater than 1% of cancer patients each year, but this varies widely by cancer type and time since diagnosis. The absolute VTE risks obtained from this review can aid in clinical decision-making about which people with cancer should receive anticoagulant prophylaxis and at what times.
format	article
author	Freesia Horsted Joe West Matthew J Grainge
author_facet	Freesia Horsted Joe West Matthew J Grainge
author_sort	Freesia Horsted
title	Risk of venous thromboembolism in patients with cancer: a systematic review and meta-analysis.
title_short	Risk of venous thromboembolism in patients with cancer: a systematic review and meta-analysis.
title_full	Risk of venous thromboembolism in patients with cancer: a systematic review and meta-analysis.
title_fullStr	Risk of venous thromboembolism in patients with cancer: a systematic review and meta-analysis.
title_full_unstemmed	Risk of venous thromboembolism in patients with cancer: a systematic review and meta-analysis.
title_sort	risk of venous thromboembolism in patients with cancer: a systematic review and meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/6f1700ee05e04fda8f07f9eaa42e173a
work_keys_str_mv	AT freesiahorsted riskofvenousthromboembolisminpatientswithcancerasystematicreviewandmetaanalysis AT joewest riskofvenousthromboembolisminpatientswithcancerasystematicreviewandmetaanalysis AT matthewjgrainge riskofvenousthromboembolisminpatientswithcancerasystematicreviewandmetaanalysis
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Risk of venous thromboembolism in patients with cancer: a systematic review and meta-analysis.

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