Essentials Cancer patients are at risk for venous thromboembolism (VTE). The riskof VTE in less advanced stage cancer on neoadjuvant chemotherapy is unclear. Inover 7800 patients, we found a 7% pooled incidence of VTE during neoadjuvanttherapy. Highest VTE rates were observed in patients with bladder and esophageal cancer.SUMMARY: Background Venous thromboembolism (VTE) is a frequentcomplication in cancer patients receiving adjuvant treatment. The risk of VTEduring neoadjuvant chemo-radiotherapy remains unclear. Objectives This systematicreview evaluated the incidence of VTE in patients with cancer receivingneoadjuvant treatment. Methods MEDLINE and EMBASE databases were searched frominception to October 2017. Search results were supplemented with screening ofconference proceedings of the American Society of Clinical Oncology (2009-2016)and the International Society of Thrombosis and Haemostasis (2003-2016). Tworeview authors independently screened titles and abstracts, and extracted dataonto standardized forms. Results Twenty-eight cohort studies (7827 cancerpatients, range 11 to 1398) were included. Twenty-five had a retrospectivedesign. Eighteen cohorts included patients with gastrointestinal cancer,representing over two-thirds of the whole study population (n = 6002, 78%). Intotal, 508 of 7768 patients were diagnosed with at least one VTE duringneoadjuvant treatment, for a pooled VTE incidence of 7% (95% CI, 5% to 10%) inthe absence of substantial between-study heterogeneity. Heterogeneity was notexplained by site of cancer or study design characteristics. VTE presented aspulmonary embolism in 22% to 96% of cases (16 cohorts), and it was symptomatic in22% to 100% of patients (11 cohorts). The highest VTE rates were observed inpatients with bladder (10.6%) or esophageal (8.4%) cancer. Conclusions Thisreview found a relatively high incidence of VTE in cancer patients receivingneoadjuvant therapy in the presence of some between-study variation, whichdeserves further evaluation in prospective studies.
Venous thromboembolism in cancer patients receiving neoadjuvant chemotherapy: a systematic review and meta-analysis
Rutjes, A. W. S.;
2018-01-01
Abstract
Essentials Cancer patients are at risk for venous thromboembolism (VTE). The riskof VTE in less advanced stage cancer on neoadjuvant chemotherapy is unclear. Inover 7800 patients, we found a 7% pooled incidence of VTE during neoadjuvanttherapy. Highest VTE rates were observed in patients with bladder and esophageal cancer.SUMMARY: Background Venous thromboembolism (VTE) is a frequentcomplication in cancer patients receiving adjuvant treatment. The risk of VTEduring neoadjuvant chemo-radiotherapy remains unclear. Objectives This systematicreview evaluated the incidence of VTE in patients with cancer receivingneoadjuvant treatment. Methods MEDLINE and EMBASE databases were searched frominception to October 2017. Search results were supplemented with screening ofconference proceedings of the American Society of Clinical Oncology (2009-2016)and the International Society of Thrombosis and Haemostasis (2003-2016). Tworeview authors independently screened titles and abstracts, and extracted dataonto standardized forms. Results Twenty-eight cohort studies (7827 cancerpatients, range 11 to 1398) were included. Twenty-five had a retrospectivedesign. Eighteen cohorts included patients with gastrointestinal cancer,representing over two-thirds of the whole study population (n = 6002, 78%). Intotal, 508 of 7768 patients were diagnosed with at least one VTE duringneoadjuvant treatment, for a pooled VTE incidence of 7% (95% CI, 5% to 10%) inthe absence of substantial between-study heterogeneity. Heterogeneity was notexplained by site of cancer or study design characteristics. VTE presented aspulmonary embolism in 22% to 96% of cases (16 cohorts), and it was symptomatic in22% to 100% of patients (11 cohorts). The highest VTE rates were observed inpatients with bladder (10.6%) or esophageal (8.4%) cancer. Conclusions Thisreview found a relatively high incidence of VTE in cancer patients receivingneoadjuvant therapy in the presence of some between-study variation, whichdeserves further evaluation in prospective studies.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
