Abstract 306: Impact of Venous Thromboembolism as Independent Predictor of Mortality Among Patients With Gastric Cancer

Abstract

Background: Cancer-associated thrombosis is a predictor of death. Patients with gastric cancer (GC) are at higher risk for VTE when compared to other solid tumors. There is a paucity of data describing the impact of VTE in GC. Aim: To measure the impact of VTE as independent predictor of gastric cancer mortality. Methods: Single institution chart review of GC treated patients (2010-15). VTE events were objectively confirmed. GC was ascertained if biopsy proven and metastatic, or on active chemotherapy. Along with cancer specific data, we abstracted risk assessments tools, non-GC specific, validated for VTE and mortality prediction in cancer; including, the Khorana Score (KRS), platelet lymphocyte ratio (PLR) and neutrophil lymphocyte ratio (NLR). Continuous variables are expressed by the by the median (interquartile range). Categorical variables are expressed as percentages. We used SPSS 23, specifically Kaplan-Meir curve and Cox proportional hazard were applied for main objectives. Results: We included 112 pts in the analysis, who were predominantly male (66%), 58 (51-64) year-old, with adenocarcinoma (84%) and advanced disease (59%). The median follow-up was 21.3 months (9.5-42.6). We measured high risk of VTE based on the KRS in 59%, 51% had an elevated NLR and 30% had an elevated PLR. VTE occurred in thirteen (12%) patients. The median time from diagnosis to VTE occurrence was 59 days (36-258). After multivariate analysis, the predictors of mortality were: VTE (Hazard Ratio (HR), 2.6; 95% CI, 1.1 to 6.0; p=0.02), Histological type (HR, 3.2; 95% CI, 1.1 to 9.2; p=0.03), Stage (HR, 2.9; 95%CI, 1.4 to 5.8; p<0.01) and PLR (HR, 2.2; 95%CI, 1.3 to 3.9); p<0.01). The one year overall survival of patients with VTE was lower than for those with no VTE (79% vs 41% p<0.05) Conclusion: VTE is associated with worse survival among patients with GC. Moreover, this finding was independent of other cancer-specific variables. NLR and KRS were not associated with survival in our GC database.