Figure - available from: Clinical and Applied Thrombosis/Hemostasis
This content is subject to copyright.
Source publication
Venous thromboembolism (VTE) is very common in patients with malignant cancer. We aimed to conduct a retrospective analysis on the risk factors of VTE and its survival prognosis of patients with malignant cancer, to provide evidence into the management of VTE. Patients with malignant cancer treated in our hospital were selected. The characteristic...
Similar publications
Digital rock analysis is a prospective approach to estimate properties of oil and gas reservoirs. This concept implies constructing a 3D digital twin of a rock sample. Focused Ion Beam - Scanning Electron Microscope (FIB-SEM) allows to obtain a 3D image of a sample at nanoscale. One of the main specific features of FIB-SEM images in case of porous...
Focused ion beam (FIB) sample preparation for electron microscopy often requires large volumes of materials to be removed. Prior efforts to increase the rate of bulk material removal were mainly focused on increasing the primary ion beam current. Enhanced yield of etching at glancing ion beam incidence is known but has not found widespread use in p...
In this study, we introduce an innovative approach to vacuum-encapsulation of MEMS resonators using Silicon Migration Seal (SMS) technology, a novel wafer-level vacuum packaging method. SMS utilizes silicon reflow phenomena under high-temperature (
$>$
1000
$^{\circ}$
C) hydrogen environments to seal release holes effectively. We successfully dem...
In recent years, computer vision technology has been widely applied in various fields, making super-resolution (SR), a low-level visual task, a research hotspot. Although deep convolutional neural network has made good progress in the field of single-image super-resolution (SISR), its adaptability to real-time interactive devices that require fast...
Citations
... There are also reports that active cancers are associated with VTE in approximately 20% of cases [8,9]. In addition, there are reports that cancer patients with VTE have a worse prognosis and higher mortality rate than those without VTE [7,10]. Anticoagulation therapy is important in the treatment of VTE, but it can cause bleeding side effects, and individual bleeding risks must be considered when using this therapy. ...
Simple Summary
Cancer increases the risk of venous thrombosis (VTE) and anticoagulant therapy is often used to treat this condition. Therefore, it is essential to identify risk factors for bleeding events in these patients. In our study, we used data from the Rising-VTE/NEJ037 study, which involved Japanese patients with advanced lung cancer, to calculate these risk factors. We found that complications with VTE were the most significant risk factor. This finding underscores the importance of carefully assessing the risks and benefits before starting anticoagulant therapy in patients with cancer. Our research aims to inform safer treatment strategies for patients with advanced lung cancer, which could have meaningful implications for their care and treatment approaches in the research community.
Abstract
Despite the occurrence of various hemorrhagic events during advanced lung cancer treatment, few researchers have reported on their risk factors. Moreover, the development of cancer-related thromboembolism indicates anticoagulant use. However, adverse events such as bleeding should be monitored. In this study, we aimed to identify factors that influence the onset of hemorrhagic events in patients with lung cancer. The Rising-VTE/NEJ037 study was a multicenter, prospective, observational study. A total of 1008 patients with lung cancer who were unsuitable for radical resection or radiation were enrolled and followed up for 2 years. Multivariate analysis using a Cox proportional hazard model was performed to compare the outcomes of the time to the onset of hemorrhagic events for 2 years after registration. Hemorrhagic events occurred in 115 patients (11.4%), with 35 (30.4%) experiencing major bleeding. Significant risk factors included venous thromboembolism (VTE) (hazard ratio [HR]: 4.003, p < 0.001) and an Eastern Cooperative Oncology Group Performance Status score of 1 (HR: 2.476, p < 0.001). Factors that significantly reduced hemorrhagic event risk were female sex (HR: 0.454, p = 0.002) and M1a status (HR: 0.542, p = 0.038). VTE is a risk factor for hemorrhagic events in patients with advanced lung cancer, and risks associated with anticoagulant therapy should be considered.
... Most studies were performed on patients with solid cancers (n ¼ 17). 13,15,[25][26][27][29][30][31][32][34][35][36][37][38]40,42,44 Studies on purely hematological cancer patients were few (n ¼ 3). 39,41,43 The remaining four studies had mixed study groups. ...
... Seven studies were performed on cancer patients undergoing surgery [25][26][27][36][37][38]44 investigating postoperative VTE, and five studies were performed in cohorts where >30% of the population underwent surgery. 19,21,30,34,35 In nine studies, all the patients received chemotherapy, 13,15,29,34,[39][40][41][42][43] and in five, studies some patients received chemotherapy. ...
... 19,21,30,34,35 In nine studies, all the patients received chemotherapy, 13,15,29,34,[39][40][41][42][43] and in five, studies some patients received chemotherapy. 19,21,30,35,38 Thromboprophylaxis was allowed in 13 studies, 15,19,21,[25][26][27]29,31,36,[38][39][40]44 and therapeutic doses were allowed in four studies. 30,32,37,41 In total, 10 out of 11 studies investigating F1.2 used the same enzyme immunoassay. ...
Venous thromboembolism (VTE) is a main contributor to morbidity and mortality in cancer patients. Biomarkers with the potential to predict cancer-associated VTE are continually sought. Of these, markers of thrombin generation present a likely option. The present systematic review examines the ability of three widely used biomarkers of thrombin generation: prothrombin fragment 1.2 (F1.2), thrombin-antithrombin complex (TAT), and ex vivo thrombin generation, to predict VTE in both solid and hematologic adult cancer patients. Relevant studies were identified in the PubMed and Embase databases, and the review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Each study was evaluated using the quality assessment tool from the National Heart, Lung, and Blood Institute. The review protocol was published on PROSPERO with identifier CRD42022362339. In total, 24 papers were included in the review: 11 reporting data on F1.2, 9 on TAT, and 12 on ex vivo thrombin generation. The quality ratings of the included studies varied from good (n = 13), fair (n = 8), to poor (n = 3) with a high heterogenicity. However, F1.2, TAT complex, and ex vivo thrombin generation were all found to be associated with the development of VTE. This association was most pronounced for F1.2. Furthermore, the determination of F1.2 was able to improve the precision of several established risk assessment scores. In conclusion, markers of thrombin generation were found to be elevated in cancer patients with VTE, and particularly, F1.2 was found to be a promising predictor of cancer-associated VTE.
... Venous endothelial damage is related to stress response and immune function [26,27]. Blood hypercoagulability can be measured by coagulation (PT and APTT) and fibrinolytic (FIB and D-D) functions [27,28]. However, the impact of thoracoscopic and thoracotomy LC resection on patients with postoperative DVT has not been thoroughly investigated. ...
The main focus of this study was to compare the predictive value of coagulation, fibrinolysis, thromboelastography, stress response, and immune function in predicting the incidence of deep venous thrombosis (DVT) in lung cancer (LC) patients undergoing thoracoscopic LC resection vs thoracotomy LC resection. To do that, a prospective, single-center, case-control study involving 460 LC patients was conducted. The risk indicators affecting patients with DVT after LC resection in the testing cohort were determined using logistic regression and receiver operator characteristic (ROC) analyses. One validation cohort was used to assess the risk prediction models. DVT incidence was higher in the thoracoscopic group (18.7%) than in the thoracotomy group (11.2%) in the testing cohort (χ
2 = 4.116, P = 0.042). The final model to predict the incidence of DVT after thoracoscopic LC excision (1 day after surgery) was as follows: Logit(P) = 9.378 – 0.061(R-value) – 0.109(K value) + 0.374(α angle) + 0.403(MA) + 0.298(FIB) + 0.406(D-D) + 0.190(MDA) − 0.097(CD4+/CD8+). For thoracotomy LC resection, the final model (3 days after operation) was: Logit(P) = –2.463 − 0.026(R-value) − 0.143(K value) + 0.402(α angle) + 0.198(D-D) + 0.237(MDA) + 0.409(SOD). In the validation cohort, this risk prediction model continued to demonstrate good predictive performance. As a result, the predictive accuracy of postoperative DVT in patients who underwent thoracoscopic LC resection and thoracotomy LC resection was improved by risk prediction models.
... 3 For patients with cancer, in addition to coping with the burden of their tumor(s), venous thromboembolism (VTE) may develop as a complication, resulting in a worsened prognosis and increased mortality risk. 4,5 The mechanism by which cancer patients are at increased risk of developing VTE is complex and is thought to involve a combination of factors. 6 It is known that in cancer patients, cancer cells can activate hemostasis through multiple pathways and thereby induce systemic hypercoagulability. ...
Impact of venous thromboembolism in Japanese colorectal cancer patients has not been elucidated. This pre-specified sub-analysis of the Cancer-VTE Registry aimed to report venous thromboembolism and event data after 1 year of follow-up in 2477 patients with colorectal cancer and investigate risk factors of venous thromboembolism. Of 2477 patients, 158 (6.4%) had venous thromboembolism in venous thromboembolism screening at enrollment. Asymptomatic distal deep vein thrombosis accounted for 123/158 (77.8%) of venous thromboembolism cases. During the follow-up period, symptomatic, incidental events requiring treatment and composite venous thromboembolism incidences were 0.3%, 0.8%, and 1.0%, respectively. The incidence of bleeding events, cerebral infarction/transient ischemic attack/systemic embolic event, and all-cause death were 1.0%, 0.3%, and 4.8%, respectively. These results were consistent with the main study results. In multivariable analysis, venous thromboembolism at baseline was a risk factor of composite venous thromboembolism during the follow-up period. Japanese patients with colorectal cancer and advancing cancer stage before treatment had more frequent venous thromboembolism complications at baseline, higher incidence of venous thromboembolism events during cancer treatment, and higher mortality.
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive type of cancer and has a poor prognosis. Patients with PDAC are at high risk of developing thromboembolic events, which is a leading cause of morbidity and mortality following cancer progression. Plasma-derived coagulation is the most studied process in cancer-associated thrombosis. Other blood components, such as platelets, red blood cells, and white blood cells, have been gaining less attention. This narrative review addresses the literature on the role of cellular components in the development of venous thromboembolism (VTE) in patients with PDAC. Blood cells seem to play an important role in the development of VTE. Altered blood cell counts, i.e., leukocytosis, thrombocytosis, and anemia, have been found to associate with VTE risk. Tumor-related activation of leukocytes leads to the release of tissue factor-expressing microvesicles and the formation of neutrophil extracellular traps, initiating coagulation and forming a scaffold for thrombi. Tissue factor-expressing microvesicles are also thought to be released by PDAC cells. PDAC cells have been shown to stimulate platelet activation and aggregation, proposedly via the secretion of podoplanin and mucins. Hypofibrinolysis, partially explained by increased plasminogen activator inhibitor-1 activity, is observed in PDAC. In short, PDAC-associated hypercoagulability is a complex and multifactorial process. A better understanding of cellular contributions to hypercoagulability might lead to the improvement of diagnostic tests to identify PDAC patients at highest risk of VTE.
Introduction:
Although many publications have reported the incidence of venous thromboembolism (VTE) in patients with cancer from Western countries, to date, no prospective East Asian studies have been published, and potential racial differences remain unclear. The multicenter, prospective, observational Cancer-VTE Registry aimed to clarify the incidence of VTE and bleeding and identify risk factors in Japanese patients with solid tumors after one year of follow-up.
Materials and methods:
Patients with colorectal, lung, stomach, pancreatic, breast, or gynecologic cancer were enrolled after VTE screening and before starting cancer treatment. The follow-up period was one year. The main outcomes were the incidences of symptomatic VTE, bleeding events (major or clinically relevant non-major), and all-cause death, evaluated according to VTE presence/absence at baseline. Multivariate analyses were conducted to identify risk factors for events.
Results:
Among 9630 patients, the one-year cumulative incidences of symptomatic VTE, bleeding events, and all-cause death were 0.5%, 1.4%, and 12.2%, respectively. The majority of VTEs identified at baseline were asymptomatic distal deep vein thromboses; however, affected patients had higher event rates during the follow-up period. The most important independent risk factor for developing symptomatic VTE, bleeding events, and death during the follow-up period was the presence of symptomatic or asymptomatic VTE at baseline.
Conclusions:
These data have revealed the incidence of symptomatic VTE in Japanese patients with solid tumors during one year of follow-up. The presence of any VTE before initiating cancer treatment was an independent risk factor for symptomatic VTE, bleeding events, and death during subsequent treatment.
