Abstract 1242P
Background
Thromboembolic events are frequent complications in cancer patients, yet knowledge about their prognostic value in gastroesophageal cancer patients is scarce.
Methods
We analyzed arterial as well as venous thromboembolic events throughout patient history and associated events at the time of first cancer diagnosis with overall survival (OS) in patients with gastroesophageal cancer, who were treated at the Medical University of Vienna between 1990 and 2020. Survival analyses were performed with log-rank analyses.
Results
We analyzed 1574 patients (70% male, mean age 63 (SD 11.8)) with gastroesophageal cancer (13% stage I, 21% stage II, 30% stage III, 36% stage IV; 79% adenocarcinoma). 79% of patients were already dead at the time of this analysis. Thromboembolic events occurred in 477 (30%) patients and 135 (28%) even experienced multiple events throughout patient history. 290 (61%) occurred in the arterial, 163 (34%) in venous and 24 (5%) in both vascular systems. The table shows the thromboembolic events of this cohort. Tumor stage was neither associated with thromboembolic events throughout patient history (p=0.370) nor with venous (p=0.421) or arterial (p=0.693) thromboembolic events at first diagnosis using the Mann-Whitney-U test. Venous thromboembolic events at first cancer diagnosis were not statistically associated with a poorer OS (with event, n=32: median OS 17.9 months (95% CI 0.0-41.3), without event: median OS 20.9 (19.3-22.5), p=0.868), neither were arterial thromboembolic events at first cancer diagnosis (with event, n=48: median OS 20.7 (15.6-25.8), without event: 21.0 (19.3-22.7), p=0.070).
Conclusions
We did not find a prognostic effect of venous or arterial thromboembolic events at diagnosis of gastroesophageal cancer. Prospective studies are warranted to further explore this issue and improve patient management. Table: 1242P
| Thromboembolic event | Before cancer diagnosis n (%) | At the time of cancer diagnosis* n (%) | After cancer diagnosis n (%) |
| DVT**- leg | 27 (2%) | 10 (0.6%) | 41 (3%) |
| Pulmonary embolism | 19 (1%) | 22 (1%) | 64 (4%) |
| DVT - arm | 3 (0.2%) | 1 (0.1%) | 14 (0.9%) |
| Splenic/portal vein | 3 (0.2%) | 1 (0.1%) | 7 (0.4%) |
| Device associated | 3 (0.2%) | 1 (0.1%) | 2 (0.1%) |
| Sinus vein | 0 | 0 | 1 (0.1%) |
| Other venous events | 4 (0.3%) | 3 (0.2%) | 4 (0.3%) |
| Myocardial infarction | 117 (7%) | 13 (0.8%) | 28 (2%) |
| Peripheral artery disease | 57 (4%) | 16 (1%) | 19 (1%) |
| Stroke | 35 (2%) | 8 (0.5%) | 24 (2%) |
| Central artery disease | 29 (2%) | 10 (0.6%) | 16 (1%) |
| Other arterial events | 6 (0.4%) | 1 (0.1%) | 5 (0.3%) |
*defined as -3 to +1 month from histological cancer diagnosis**deep vein thrombosis
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
H.C. Puhr: Other, Institutional, Other: HC.P. has received travel support from Eli Lilly, MSD, Novartis, Pfizer and Roche and received lecture honoraria from Eli Lilly.. A.S.S. Berghoff: Other, Institutional, Other: AS.B. has received research support from Daiichi Sankyo and Roche, honoraria for lectures, consultation or advisory board participation from Roche, Bristol-Meyers Squibb, Merck, Daiichi Sankyo as well as travel support from Roche, Amgen, Daiichi Sankyo an. M. Preusser: Other, Institutional, Other: M.Pr. has received honoraria for lectures, consultation or advisory board participation from the following for-profit companies: Bayer, Bristol-Myers Squibb, Novartis, Gerson Lehrman Group (GLG), CMC Contrast, GlaxoSmithKline, Mundipharma, Roche, BMJ Jour. A. Ilhan-Mutlu: Other, Institutional, Other: A.I-M. participated in advisory boards from MSD, BMS and Servier, received lecture and consultation honoraria from Eli Lilly, MSD, Servier and Astellas, is the local PI for clinical trials sponsored by BMS, Roche and Amgen and received travel support from. All other authors have declared no conflicts of interest.