Abstract

BackgroundThe occurrence of venous thromboembolism (VTE) in patients with cancer leads to a reduced life expectancy. There is an increased incidence of cancer and its associated mortality in Uganda. We described the survival and characteristics of patients with cancer associated thrombosis (CAT) in a tertiary oncology centre in Uganda.MethodsWe performed a retrospective study on patients with CAT at the Uganda Cancer Institute (UCI) using a homogenous purposive sampling method.ResultsOne hundred and eleven patients with documented VTE were included in the analysis. At entry, the mean age was 52.4 years, and 69 were female. Ninety eight had deep venous thrombosis, while 12 had pulmonary embolism. The most common cancer diagnoses were haematologic (30), gynaecologic (20) and prostate (17) cancers. Treatment regimens included anticoagulation with low-molecular weight heparin (LMWH) (72) and combined LMWH with warfarin (22). The median overall survival (OS) was 6.3 months, with a 1-year survival rate of 41.5%. Patients with significantly increased hazard of mortality were those with upper gastrointestinal (UGI) malignancies, colorectal and breast cancers. Patients with a body mass index of 25–29.9 kg/m2 (overweight) had a slightly reduced hazard of mortality.ConclusionThe OS of patients with CAT at the UCI is short. Most patients with CAT presented with advanced stage cancers and at a relatively young age. Patients with UGI, colorectal and breast cancers had increased hazards of mortality, whereas those who were overweight had a slight reduction in the hazard of mortality.

Highlights

  • The occurrence of venous thromboembolism (VTE) in patients with cancer leads to a reduced life expectancy

  • Patients with cancer have a 4- to 7-fold increased risk of suffering from venous thromboembolism (VTE) events, including deep venous thrombosis (DVT) and pulmonary embolism (PE) [1], a risk that is further augmented by cancer treatment [2, 3]

  • The type of cancer is a strong predictor, with the strongest association being with malignant tumours of the pancreas, lung, stomach, adenocarcinomas of unknown primary, and of the ovary and brain; patients with locally advanced cancers and those with distant metastases may be at increased risk of a VTE

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Summary

Introduction

The occurrence of venous thromboembolism (VTE) in patients with cancer leads to a reduced life expectancy. The type of cancer is a strong predictor, with the strongest association being with malignant tumours of the pancreas, lung, stomach, adenocarcinomas of unknown primary, and of the ovary and brain; patients with locally advanced cancers and those with distant metastases may be at increased risk of a VTE. Combination chemotherapy, including antiangiogenic agents, reportedly heightens the risk [3, 4]

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