Venous thromboembolism risk in patients with locoregional urothelial tract tumors Journal Article

Authors: Ramos, J. D.; Wingate, J. T.; Gulati, R.; Plimack, E. R.; Harshman, L. C.; Powles, T.; Crabb, S. J.; Niegisch, G.; Bellmunt, J.; Ladoire, S.; De Giorgi, U.; Hussain, S.; Alva, A. S.; Baniel, J.; Agarwal, N.; Rosenberg, J. E.; Vaishampayan, U. N.; Galsky, M. D.; Yu, E. Y.; RISC Investigators
Article Title: Venous thromboembolism risk in patients with locoregional urothelial tract tumors
Abstract: There is limited data on venous thromboembolism (VTE) risk in patients with locoregional urothelial tract tumors. We performed a multicenter, retrospective study of 1732 patients assessing VTE rate, associative factors, and impact on survival in this population. Our study identified a high VTE rate (7.6%) and several factors associated with increased risk including non-urothelial histology, renal dysfunction, and cardiovascular disease. Background: Venous thromboembolism (VTE) is common in cancer patients, but there is limited data on patients with urothelial tract tumors (UTT). We previously identified several associative factors for increased VTE rates in patients with metastatic UTT. In this study, we assessed the frequency, associative factors, and impact on survival of VTE in patients with locoregional UTT. Methods: Patients with locoregional bladder, upper urinary tract, or urethral cancer were included in this multi-center study from 29 academic institutions. Patients with < cT2, > N1, or M1 disease at diagnosis were excluded. Patients with incomplete clinical staging or miscoded/missing data were excluded. Cumulative, unadjusted VTE incidence was calculated from time of diagnosis of muscle-invasive disease, excluding VTEs diagnosed in the metastatic setting. χ2 statistics tested differences in VTE rates across baseline and treatment-related factors. Significant covariates were incorporated into a multivariate, logistic regression model. Overall survival stratified by VTE was estimated using Kaplan-Meier methods and evaluated using the log-rank test. Results: A total of 1732 patients were eligible. There were 132 (7.6%) VTEs. On multivariate analysis, non-urothelial histology (P <.001), clinical Nx stage (P <.001), cardiovascular disease (P =.01), and renal dysfunction (P =.04) were statistically significant baseline factors associated with VTE. Using surgery alone as reference, surgery with perioperative chemotherapy (P =.04) and radiation with concurrent chemotherapy (P =.04) also were significant. Conclusions: The VTE incidence of 7.6% in locoregional disease is comparable with our previously reported rate in the metastatic setting (8.2%). Similar to our findings in metastatic UTT, non-urothelial histology, renal dysfunction, and CVD was associated with increased VTE risk. © 2017 Elsevier Inc.
Keywords: bladder cancer; thrombosis; metastatic; localized; non-urothelial
Journal Title: Clinical Genitourinary Cancer
Volume: 16
Issue: 1
ISSN: 1558-7673
Publisher: Elsevier Inc.  
Date Published: 2018-02-01
Start Page: e161
End Page: e167
Language: English
DOI: 10.1016/j.clgc.2017.08.001
PROVIDER: scopus
PMCID: PMC5826750
PUBMED: 28923700
Notes: Article -- Export Date: 3 December 2018 -- Source: Scopus
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  1. Jonathan Eric Rosenberg
    240 Rosenberg