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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

4114 - Venous thromboembolism during preoperative chemotherapy in the CRITICS gastric cancer trial

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Presenters

Astrid Slagter

Citation

Annals of Oncology (2018) 29 (suppl_8): viii205-viii270. 10.1093/annonc/mdy282

Authors

A.E. Slagter1, K. Sikorska2, C. Grootscholten3, H.W.M. van Laarhoven4, H. Boot5, E. Meershoek-Klein Kranenbarg6, C.J.H. van de Velde6, N.C. van Grieken7, E.P.M. Jansen8, M. Verheij1, A. Cats5

Author affiliations

  • 1 Radiation oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, 1066 CX - Amsterdam/NL
  • 2 Biometrics, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, 1066 CX - Amsterdam/NL
  • 3 Medical Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, 1006 BE - Amsterdam/NL
  • 4 Medical Oncology, Academic Medical Center, University of Amsterdam, 1100 DD - Amsterdam/NL
  • 5 Gastrointestinal Oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, 1066 CX - Amsterdam/NL
  • 6 Surgical oncology, Leiden University Medical Center, 2333ZA - Leiden/NL
  • 7 Pathology, Vrije University Medical Center (VUMC), 1081 HV - Amsterdam/NL
  • 8 Radiation oncology, The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital, 1066CX - Amsterdam/NL
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Resources

Abstract 4114

Background

Venous thromboembolism (VTE) is a common complication in patients with cancer. Gastric cancer (GC) has been associated with one of the highest risks of VTE. Risk factors for VTE in GC have mainly been investigated in Asian populations and/or in metastasised setting and include: gender, age, body mass index (BMI), stage, primary tumour localisation and chemotherapy, in particular cisplatin. Limited data is available on risk factors for VTE in resectable GC in Western patients. The aim of this study was to identify risk factors for VTE during preoperative chemotherapy in resectable GC patients. In addition, we addressed the question whether VTE was a risk factor for not proceeding to surgery.

Methods

Patients with resectable GC selected from the CRITICS trial (stages Ib-IVa; American Joint Cancer Committee, sixth edition; no distant metastasis) should preoperatively be treated with 3 cycles of 3-weekly epirubicin, cisplatin/oxaliplatin and capecitabine (ECC or EOC). Inclusion criterion for this analysis was start of at least 1 chemotherapy cycle. VTE was defined as any thrombus in the venous system, excluding superficial and/or device related VTE. Risk factors of interest were fitted in a multivariable logistic regression model: age, gender, BMI, ECC/EOC and tumour localisation.

Results

A total of 781 patients were included in this analysis of whom 78 (10%) developed a VTE during the preoperative period. Results of the multivariable analysis are shown in the table. Seventy four patients with VTE proceeded to surgery (95%), compared to 666 patients (95%) without VTE (p = 0.99).Table: 691P

Multivariable analysis

VariableNo VTE (n = 703)VTE (n = 78)OR (95%CI)p value
n%n%
Age in years<6028791289*
60-692618834121.31 (0.76-2.23)0.329
70+155911691.01 (0.53-1.94)0.970
GenderMale47491499*
Female2298929111.20 (0.72-1.98)0.483
BMI¤<2536892338*
25-302469028101.30 (0.76-2.21)0.342
≥30888417162.16 (1.14-4.09)0.018
ECC/EOCECC564896811*
EOC139931070.61 (0.30-1.22)0.162
Tumour localisationDistal223882912*
Middle2098926110.96 (0.54-1.68)0.877
Proximal150941060.52 (0.24-1.12)0.094
GOJ1219013100.87 (0.43-1.76)0.693

* reference; ¤ BMI unknown (n = 1); OR= Odds Ratio; CI= Confidence Interval

Conclusions

High BMI (≥30) was the only independent risk factor for developing VTE in resectable GC, preoperatively treated with ECC/EOC. Cisplatin was not identified as a significant risk factor for VTE in this cohort. A diagnosis of VTE did not influence the clinical decision to proceed to surgery.

Clinical trial identification

NCT00407186.

Legal entity responsible for the study

Netherlands Cancer Institute.

Funding

Dutch Cancer Society, Dutch Colorectal Cancer Group, and Hoffmann-La Roche.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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