Management of thrombosis in cancer patients in Greece

Background: Venous thromboembolism (VTE) is a common cause of adverse outcomes in patients with cancer. The risk of VTE varies with cancer type, stage, grade, therapy and other patient characteristics. Low-molecular-weight heparin (LMWH) remains the standard therapy for VTE in cancer patients. Methods: This is an observational study conducted by the Hellenic Society of Medical Oncologists (HeSMO) that aims to record and highlight the current clinical practice and management of VTE in patients with cancer in 18 Greek centers, with nationwide dispersion. Results: The participating centers reported a total of approximately 4300 cancer patients managed on a monthly basis, where the vast majority (80%) were treated in an outpatient setting. For this study, 340 patients with active cancer were enrolled, with the following characteristics: 53,2% male; mean age 64,3; 62.1% of patients had PS of 0-1; tumor types: lung 22,3%, pancreas 16,3%, colon 13,6%, breast 11%, stomach 8,3%, ovarian 6,5% and other tumors 21,7%. The majority of patients (95,3%) received anticancer treatment; 21,3% were inpatients and 78,6% outpatients. Among these 340 patients, 86 were diagnosed with VTE: 81,4% had symptomatic VTE while 18,6% had incidental VTE. Regarding patients with VTE,94,2% received anticancer treatment and the majority of these (65,1%) were treated in an outpatient setting. Of the patients diagnosed with VTE, 76,9% had performance status 0-1 and 74,4% had metastatic disease. In the metastatic stage there was no differences in the incidence of symptomatic or incidental VTE, 75% vs 74,3% respectively (p = 0,99). Highest percentage of incidental VTE observed was in patients with lung cancer (43,8%), followed by pancreatic (18,8%) and colon cancer (12,5%). All patients with VTE received antithrombotic treatment with LMWH according to the current clinical guidelines. Conclusions: The majority of patients who developed VTE were outpatients undergoing anticancer treatment with metastases. Incidental VTE was more frequent in patients with lung cancer. Our findings of 18,6% incidental VTE further confirm the previously described results in similar studies. Legal entity responsible for the study: Hellenic Society of Medical Oncology (HeSMO) Funding: None Disclosure: All authors have declared no conflicts of interest.