2083P - Association between VTE location and risk of recurrent, bleeding and death in the international prospective TESEO SEOM cancer cohort

Background

Cancer patients (pt) with venous thromboembolism (VTE) face increased risks of recurrent thrombosis and bleeding, yet information on associated risk factors remains scarce.

Methods

The TESEO-SEOM prospective, multicenter and international registry involved a descriptive analysis of 2,825 consecutive pt examining thrombosis recurrence and bleeding patterns. The Chi2 test compared recurrent VTE and bleeding events based on primary tumor and thrombosis location.

Results

The table shows the clinical characteristics of the cohort. 173 pt (6.1%) presented recurrent VTE and 188 pt (6.7%) had major or clinically relevant bleeding. Both events correlated with a higher risk of death (adjusted p<0.01 and p<0.001, respectively). GI cancer was significantly associated with a higher risk of recurrent VTE (86 pt, 7.6%, p=0.010). Bleeding episodes were also more frequent in GI tumors, but without statistical significance (87 pt, 7.7%, p=0.090). Adjusted for gender, age, stage (metastatic vs. localized) and location of primary tumor, splanchnic VTE was associated with a higher risk of recurrent VTE (11.2%, p=0.027) and bleeding (11.7%, p=0.018) compared to the whole cohort. This difference was not identified in the rest of the abdomen/pelvis. However, splanchnic VTE was not associated with increased mortality risk (p=0.148) Pulmonary embolism was also associated with bleeding (119 pt, 7.7%, p= 0.006) but not with recurrent VTE. Pulmonary embolism correlated with higher death rates (p= 0.007). Other VTE locations were not associated with higher bleeding or recurrent VTE risk. Table: 2083P

Baseline characteristics

Conclusions

A thrombotic event localized in splanchnic circulation is associated with higher risk of recurrent thrombosis and bleeding, regardless of age, sex and tumor type, although it does not seem to impact mortality. Pulmonary embolism is linked to a higher bleeding and mortality risk.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

TESEO-SEOM.

Funding

Sanofi, Leo Pharma, Rovi, BMS-Pfizer Alliance.

Disclosure

R. Martín Lozano: Non-Financial Interests, Institutional, Funding: Sanofi. J.A. Santiago Crespo: Financial Interests, Personal and Institutional, Speaker, Consultant, Advisor: Servier, Pierre Fabre, Merck, Bayer, Fresenius Kabi, Amgen. L. Ortega Morán: Financial Interests, Personal and Institutional, Invited Speaker: Rovi, Leo Pharma, Menarini, Servier. A.J. Munoz Martin: Financial Interests, Personal and Institutional, Speaker, Consultant, Advisor: Servier, Sanofi, Pfizer, BMS, AstraZeneca, MSD, Roche, GSK, Taiho Oncology, Leo Pharma; Financial Interests, Personal and Institutional, Speaker’s Bureau: Rovi, Stada, Menarini, Amgen, Merck; Financial Interests, Institutional, Research Funding: Rovi, Celegne, Leo Pharma; Financial Interests, Personal, Other, Travel: AstraZeneca, Amgen, Merck, Roche. All other authors have declared no conflicts of interest.