Incidence of Thromboembolic Events in Patients Treated with Cisplatin-Based Chemotherapy

ABSTRACT Introduction Cancer patients on chemotherapy have higher risk in developing thromboembolic events (TEE), with great impact on morbidity and mortality. The aim of this study is to determine the incidence of venous and arterial TEE in patients treated with cisplatin-based chemotherapy. We also analysed the prognostic value of patientś baseline and treatment characteristics in predicting TEE occurrence. Methods We performed a retrospective analysis of all patients with cancer treated with cisplatin-based chemotherapy between January 1, 2011, and April 10, 2012, with at least 4 weeks of follow-up after their last cisplatin dose. A TEE was considered cisplatin-associated if it occurred between the time of the first dose of cisplatin and 4 weeks after the last dose. Results Among 141 patients, 27 (19.1%) experienced a TEE. The TEE observed were: deep vein thrombosis (DVT) in 9.9% (14), pulmonary embolism (PE) in 5.7% (8), DVT plus PE in 0.7% (4) and arterial thrombosis in 2.8%. The majority of patients (51.9%) had a TEE after 63 days, and after the 3rd dose of cisplatin, with a cumulative dose of 160 mg/m2. By univariate analysis, active smoking (p = 0.016), hypertension (p = 0.007), site of cancer (p = 0.025), Khorana site of cancer (p = 0.001), Khorana score (p = 0.049) and risk group (p = 0.04) were all identified as risk factors. However, by multivariate analysis, only hypertension (p = 0.18; HR 3.59; 95% CI, 1.25 to 10.34) and Khorana site of cancer (p = 0.03) retained statistic significance. Conclusion As we expected, gastric and pancreatic cancers had the highest incidence of TEE. We verified a very high incidence of TEE in patients treated with cisplatin-based regimens, also described in other published studies. It is therefore important to carry out randomized studies to conclude the need for prophylaxis of TEE in these patients. Disclosure All authors have declared no conflicts of interest.