Abstract 457P
Background
Cancer patients have a significantly higher risk of developing venous thromboembolism (VTE) compared to the general population. But there are no data on the management of cancer associated VTE at the end of life and no guidance when to stop anticoagulation for the imminent death in hospice care.
Methods
We retrospectively reviewed 153 VTE patients with advanced cancer who were treated with anticoagulation in our hospital from January 2016 to December 2022.
Results
Total 153 patients managed with anticoagulation for the treatment and secondary prevention for cancer associated VTE were enrolled. The median age of patients with 66 years and 69% of patients were female. The median duration of treatment with anticoagulation was 92.3 days. 42% of patients were receiving prophylactic anticoagulation, most frequently low molecular weight heparin. Of these patients, 47 patients continued anticoagulation therapy until death, 22 patients up to 7 days prior to death, 14 patients up to 28 days to 8 days and 15 patients over 1 month. Clinically relevant non-major bleeding was recorded 8 patients. However, bleeding rates increased closer impending death with 6 patients of bleeding in the last 7 days of life. No data were recorded suggestive of recurrence VTE or major bleeding. Despite specialized palliative consultation, at the time of death 30% of patients were still on prophylactic anticoagulation.
Conclusions
The majority of advanced cancer patients with VTE were managed with anticoagulation up to or within days of death in real world. Patients with poor performance status and short prognosis are unlikely to benefit from anticoagulation. Given the absence of guidelines about the use of anticoagulation in terminal cancer patients, it should be an early and multidisciplinary decision. It will be a strategy to improve a rational policy of anticoagulation and to prevent bleeding complication.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.
Resources from the same session
173P - Lenvatinib (L) versus sorafenib (S) second-line therapy in hepatocellular carcinoma (HCC) patients progressed to atezolizumab plus bevacizumab (AB)
Presenter: Mara Persano
Session: Poster Display
Resources:
Abstract
174P - Unlocking the potential of blood-based biomarkers in pancreatic cancer for early detection and therapeutic screening
Presenter: Belinda Lee
Session: Poster Display
Resources:
Abstract
175P - Genomic evolution of peritoneal metastasis in gastric adenocarcinoma
Presenter: Lan Tu
Session: Poster Display
Resources:
Abstract
176P - Identification of novel diagnostic markers for pancreatic neuroendocrine tumors by proteomics with patient blood
Presenter: HEE SEON Kim
Session: Poster Display
Resources:
Abstract
177P - Burden of stomach cancer attributable to smoking in South Asia from 1990-2019, its projection of deaths to 2040: A benchmarking and comparative analysis
Presenter: Pranay Vaghela
Session: Poster Display
Resources:
Abstract
178P - Survival benefit of splenic hilar lymph nodes (no.10) dissection in B4 type gastric carcinoma: An IPTW propensity score analysis of large multi-institutional data
Presenter: Oh Jeong
Session: Poster Display
Resources:
Abstract
179P - The impact of pre-operative nutritional/rehabilitative assessments and support on postoperative outcomes in very elderly gastric cancer patients
Presenter: Yuki Ushimaru
Session: Poster Display
Resources:
Abstract
180P - Appraisal of surgical outcomes and oncological efficiency of intraoperative adverse events in robotic radical gastrectomy for gastric cancer
Presenter: shangguan Zhixin
Session: Poster Display
Resources:
Abstract
181P - TQB2450 (PD-L1 blockade) in combination with anlotinib as a perioperative treatment for patients with hepatocellular carcinoma at high risk of recurrence: Primary results from a prospective, single-arm, phase Ib study
Presenter: Zhen Huang
Session: Poster Display
Resources:
Abstract
182P - Cytoreductive surgery and chemotherapy in metastatic gastric adenocarcinoma: A population-based study
Presenter: Dana Al Zamer
Session: Poster Display
Resources:
Abstract