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Previous Volume 343:1846-1850 December 21, 2000 Number 25 Next

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ABSTRACT

Background Little is known about the prognosis of cancer discovered during or after an episode of venous thromboembolism.

Methods We linked the Danish National Registry of Patients, the Danish Cancer Registry, and the Danish Mortality Files to obtain data on the survival of patients who received a diagnosis of cancer at the same time as or after an episode of venous thromboembolism. Their survival was compared with that of patients with cancer who did not have venous thromboembolism (control patients), who were matched in terms of type of cancer, age, sex, and year of diagnosis.

Results Of 668 patients who had cancer at the time of an episode of deep venous thromboembolism, 44.0 percent of those with data on the spread of disease (563 patients) had distant metastasis, as compared with 35.1 percent of 5371 control patients with data on spread (prevalence ratio, 1.26; 95 percent confidence interval, 1.13 to 1.40). In the group with cancer at the time of venous thromboembolism, the one-year survival rate was 12 percent, as compared with 36 percent in the control group (P<0.001), and the mortality ratio for the entire follow-up period was 2.20 (95 percent confidence interval, 2.05 to 2.40). Patients in whom cancer was diagnosed within one year after an episode of venous thromboembolism had a slightly increased risk of distant metastasis at the time of the diagnosis (prevalence ratio, 1.23 [95 percent confidence interval, 1.08 to 1.40]) and a relatively low rate of survival at one year (38 percent, vs. 47 percent in the control group; P<0.001).

Conclusions Cancer diagnosed at the same time as or within one year after an episode of venous thromboembolism is associated with an advanced stage of cancer and a poor prognosis.

Source Information

From the Departments of Clinical Epidemiology and Medicine V, Aarhus University Hospital and Aalborg Hospital, Aarhus, Denmark (H.T.S.); the Danish Cancer Society, Institute of Cancer Epidemiology, Copenhagen, Denmark (L.M., J.H.O.); and the Departments of Medicine and Community and Family Medicine, Dartmouth Medical School, Hanover, N.H. (J.A.B.).

Address reprint requests to Dr. Sørensen at the Department of Clinical Epidemiology, Aarhus University Hospital, Vennelyst Blvd. 6, Bldg. 260, DK-8000 Aarhus C, Denmark, or at hts{at}soci.au.dk.

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