Venous thromboembolic events in glioblastoma patients: An epidemiological study. (31st May 2022)

• Record Type: Journal Article
• Authors: Eisele, Amanda; Seystahl, Katharina; Rushing, Elisabeth J.; Roth, Patrick; Le Rhun, Emilie; Weller, Michael; Gramatzki, Dorothee
• Is Part Of: European journal of neurology. Volume 29:Number 8(2022)
• Page Start: 2386
• Page End: 2397
• Publication Date: 2022-05-31
• Subjects: anticoagulation -- bleeding -- epidemiology -- glioblastoma -- VTE; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.8
• DOI: 10.1111/ene.15404
• Languages: English
• ISSNs: 1351-5101

Abstract

Abstract: Background and purpose: Venous thromboembolic events (VTEs) are a major complication in cancer patients, and therefore, also in brain cancer patients, anticoagulants are considered appropriate in the treatment of VTEs. Methods: Frequency, risk factors, and treatment of VTEs, as well as associated complications, were assessed in a population‐based cohort of glioblastoma patients in the Canton of Zurich, Switzerland. Correlations between clinical data and survival were retrospectively analyzed using the log‐rank test and Cox regression models. Results: Four hundred fourteen glioblastoma patients with isocitrate dehydrogenase wild‐type status were identified. VTEs were documented in 65 patients (15.7%). Median time from tumor diagnosis to the occurrence of a VTE was 1.8 months, and 27 patients were diagnosed with VTEs postoperatively (within 35 days; 42.2%). History of a prior VTE was more common in patients who developed VTEs than in those who did not ( p = 0.004). Bevacizumab treatment at any time during the disease course was not associated with occurrence of VTEs ( p = 0.593). Most patients with VTEs ( n = 61, 93.8%) were treated with therapeutic anticoagulation. Complications occurred in 14 patients (23.0%), mainly intracranial hemorrhages ( n = 7, 11.5%). Overall survival did not differ between patients diagnosed with VTEs and those who had no VTE ( p = 0.139). Tumor progression was the major cause of death ( n = 283, 90.7%), and only three patients (1.0%) died in association with acute VTEs. Conclusions: Venous thromboembolic events occurred early in the disease course, suggesting that the implementation of primary venous thromboembolism prophylaxis during first‐line chemoradiotherapy could be explored in a randomized setting. Abstract : Venous thromboembolic events (VTEs) are a major complication in cancer patients. Frequency, risk factors, and treatment of VTEs, as well as associated complications, were assessed in a population‐based cohort of 414 glioblastoma patients in the Canton of Zurich, Switzerland. VTEs occurred early in the disease course, suggesting that the implementation of primary venous thromboembolism prophylaxis during first‐line chemoradiotherapy could be explored in a randomized setting.