Published online Apr 15, 2017. doi: 10.4251/wjgo.v9.i4.176
Peer-review started: December 6, 2016
First decision: January 7, 2017
Revised: January 22, 2017
Accepted: February 28, 2017
Article in press: February 28, 2017
Published online: April 15, 2017
Processing time: 125 Days and 19.7 Hours
To investigated the incidence and risk factors of venous thromboembolism (VTE) in patients with advanced gastric cancer (AGC) receiving chemotherapy.
All consecutive chemotherapy-naïve patients with AGC who would receive palliative chemotherapy between November 2009 and April 2012 in our hospital were recruited. Their pretreatment clinical and laboratory variables, including D-dimer, were recorded. The frequency of VTE development and survival rates during each chemotherapy cycle and regularly thereafter were assessed.
A total of 241 patients enrolled between November 2009 and April 2012 were analyzed. During a median follow-up duration of 10.8 mo (95%CI: 9.9-11.7), 27 patients developed VTE and the incidence of VTE was 17.5% (95%CI: 10.5-24.0, 12.0 events/100 person-years). The 6-mo and 1-year cumulative incidences were 7.8% (95%CI: 4.2%-11.4%) and 12.4% (95%CI: 7.3-17.2), respectively. Thirteen (48.1%) patients were symptomatic and the other 14 (51.9%) patients were asymptomatic. In multivariate analysis, pretreatment D-dimer level was the only marginally significant risk factor associated with VTE development (hazard ratio = 1.32; 95%CI: 1.00-1.75, P = 0.051).
The incidence of VTE is relatively high in patients with AGC receiving chemotherapy, and pretreatment D-dimer level might be a biomarker for risk stratification of VTE.
Core tip: The incidence of venous thromboembolism (VTE) is relatively high in patients with advanced gastric cancer receiving chemotherapy, and pretreatment D-dimer level is a risk factor for VTE. Considering the usefulness of D-dimer as a biomarker given its ease of use and low cost, pretreatment D-dimer might be a risk stratification factor for VTE development and patient selection for thromboprophylaxis.