Abstract 785P
Background
We aimed to evaluate arterial and venous TE incidence and risk factors during first-line CBCT for metastatic TC, and to evaluate the impact of TE on long-term survival.
Methods
In this historical prospective population-based study, men who initiated first-line CBCT in the period 2000 through 2014 at three of four University Hospitals in Norway were included. Clinical variables including laboratory parameters at first CBCT cycle and follow-up status were retrieved from medical records. Arterial TE (ATE) and venous TE (VTE) diagnosed shortly prior to the start of CBCT or during chemotherapy until three months after completed CBCT were registered. Age-adjusted logistic regression and Cox regression were performed to identify possible risk factors for VTE, and the impact of TE on long-term survival.
Results
In total 506 patients were included. Median age at first CBCT cycle was 33.4 years; median follow-up time was 8.7 years. Overall, 69 men (13.6%) were diagnosed with 70 TE. Twelve men (2.6%) experienced ATE (five myocardial infarction); the majority had one or more cardiovascular risk factors. Overall, 58 men (11.5%) had VTE, most commonly pulmonary embolism (n=30). Age-adjusted univariable logistic regression identified retroperitoneal lymph node (RPLN) metastasis > 5 cm, poor prognosis group, Khorana score >1, central venous access, reduced renal function and elevated CRP (≥ 20 mg/ml) as VTE risk factors. In multivariable logistic regression analyses, increasing age at diagnosis (OR per year 1.04, 95% CI 1.04-1.07), RPLN metastasis > 5 cm (OR 2.24, 95% CI 1.01-4.96) and elevated CRP (OR 3.57, 95% CI 1.62-7.87) were significantly associated with VTE risk. Thromboprophylaxis did not influence the risk of VTE (VTE incidence 13% vs. 11%, p=0.61). Two men died of TE. The cumulative 10-year overall survival was 94% among men without TE, and 87% among men with TE. TE during the CBCT treatment period was associated with increased overall mortality (HR 1.97, 95% CI 0.93-4.2).
Conclusions
We confirmed a high incidence rate of TE at 13.6%. Elevated CRP emerged as a possible new risk factor for VTE in this patient population. TE during CBCT might influence long-term survival.
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.