Clinical features of cancer-related isolated distal deep vein thrombosis / 中华老年医学杂志

ABSTRACT

Objective To investigate clinical features and prognosis of patients with cancerrelated isolated distal deep vein thrombosis(IDDVT).Methods Data of 64 patients with malignant tumor complicated with IDDVT at our hospital from January 2003 to January 2013 were retrospectively analyzed for the clinical features and prognosis.Results Among the 64 patients,32 male and 32 female cases were involved,aged 37 to 87 years,average(66.0 ± 12.6) years.There were 42 cases aged 65 years and older and 22 cases aged under 65 years.The IDDVT involved veins of lower extremity in 64 patients,unilaterally (47/64)or bilaterally (17/64).The intermuscular veins were involved by IDDVT in 46 cases(71.9％).Posterior tibial veins were involved in 17 cases(26.6％),peroneal veins were involved in 14 cases(21.9％),anterior tibial veins were involved in 2 cases (3.1 ％).Common symptoms were swollen lower extremity and pain (53.1％).Bleeding occurred in 2 (3.6 ％) of the 55 patients(55/64,85.9 ％) who underwent anticoagulant therapy,and no major bleeding occurred.The cumulative incidence of IDDVT at 3,6,and 12 months after tumor diagnosis was 64.0％ (41/64 cases),75.0 ％ (48/64 cases) and 85.9 ％ (55/64 cases),respectively.The cumulative incidences of IDDVT at 3 and 6 months were higher after diagnosis of lung cancer than after diagnosis of digestive tract tumors(P =0.005 and 0.035).By the end of follow-up(a median follow-up of 13.0 months),30 patients(46.9 ％)died.The mortality rate was lower in the non-elderly group than in the elderly group (22.7％ vs.59.5％,x2 =7.850,P=0.005).The mortality rate was lower in patients with stage Ⅰ-Ⅲa than in patients with stage Ⅲb-Ⅳ(24.0％ vs.68.8％,x2=11.246,P=0.001).The mortality rate was lower in patients with gynecologic tumors(10.0％) than in patients with lung cancer(55.6％),digestive tract tumors (40.0％) and hematologic tumors (71.4％) (P =0.041,0.037 and 0.035,respectively).TNM Ⅲ b-Ⅳ (OR =8.42,95 ％ CI1.93-30.00,P =0.004) and age ≥ 65 years (OR =6.28,95％CI1.50-27.76,P=0.012)were independent risk factors for death.Conclusions Cancerassociated IDDVT most commonly involves the intermuscular veins.The incidence of hemorrhage after anticoagulant therapy is low.For patients without anticoagulation contraindications,active anticoagulant therapy should be recommended.The advanced cancer and old age are independent risk factors for cancer-related IDDVT death.