454P - To study the prevalence of lower limb deep vein thrombosis in patients who present with stage III/IV solid tissue malignancies in Indian patients

Background

Deep Vein Thrombosis and Pulmonary Embolism have been associated with significant morbidity and mortality worldwide. The risk of developing lower limb Deep Vein Thrombosis may be associated with cancer-related, patient, and treatment-related risk factors. Although the association between cancer and venous thromboembolism is well known, there is a paucity of information in Asian patients with respect to cancer-associated thrombosis.

Methods

This prospective, observational study was conducted at Artemis Hospital, Gurugram, a Tertiary Health Care Center in (Northern) India. We identified all the consecutive patients with histologically confirmed newly diagnosed Stage III/IV solid tissue malignancies between June 2021 and May 2022. Duplex Doppler Ultrasound of the bilateral lower limb was performed to determine the prevalence of Deep Vein Thrombosis. Data on clinical and tumor characteristics were collected and compared among patients with and without lower limb Deep Vein Thrombosis.

Results

A total of 100 patients were enrolled in the study. On Duplex Doppler venous ultrasound, the prevalence of lower limb deep vein thrombosis was 14%. An adjusted multivariable regression analysis showed that advanced stage (p=0.008), leukocytosis(p=0.042), OR[1.0],95% CI(1.00,1.2), deranged coagulation profile (Raised APTT, PT)(p=0.01),OR [1.74], 95%CI(1.14,2.679) hypercholesterolemia(p=0.007), OR[1.02], 95%CI (1.004,1.05) were independent predictors of Deep vein Thrombosis. The highest prevalence of venous thromboembolism was for pancreatic (2%) and lung cancer (2%).

Conclusions

Cancer-related thrombosis has to bear in treatment outcomes as well as morbidity and mortality. Routine lower-extremity Venous Doppler Ultrasonographic screening is useful for early detection and management at an initial evaluation of stage III/IV solid malignancies. There is a paucity of data on Indian patients. This is the first study conducted in the Indian subcontinent that has identified high-risk factors and prevalence of venous thromboembolism. Such study design will help us in formulating national-level guidelines for prophylaxis of cancer-associated thrombosis.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.