Incidence, risk factors, and outcomes of central venous catheter-related thromboembolism in breast cancer patients: the CAVECCAS study

Autor: Issa Kalidi, Philippe Debourdeau, Sylvie Chevret, Kristell Desseaux, Sylvie Giachetti, Joseph Gligorov, Antoine Elias, Corinne Frere, Marc Espié, Dominique Farge, Stéphane Villiers, Pierre Francois Dupré
Přispěvatelé: Département d'Oncologie (Dep Oncol - AVIGNON), Institut Ste Catherine, Centre des maladies du sein, Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Biostatistique et épidemiologie clinique, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Oncologie médicale [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Alliance Pour la Recherche En Cancérologie [CHU Tenon] (APREC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer - Hôpital Sainte-Musse, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de biostatistique et d'informatique médicale, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Saint-Louis, Hôpital Saint-Louis, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), HAL-UPMC, Gestionnaire, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
Cancer Research
medicine.medical_treatment
central venous catheter
Comorbidity
030204 cardiovascular system & hematology
chemotherapy
Body Mass Index
0302 clinical medicine
Breast cancer
Cell-Derived Microparticles
Medicine
Central Venous Catheters
Thrombophilia
risk factors
Prospective Studies
Prospective cohort study
Original Research
Incidence (epidemiology)
Incidence
Carcinoma
Ductal
Breast
Age Factors
Thrombin
Middle Aged
3. Good health
Pulmonary embolism
[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Oncology
030220 oncology & carcinogenesis
Female
Internal Medicine Unit
medicine.symptom
Cancer Prevention
Central venous catheter
Blood Platelets
medicine.medical_specialty
venous thromboembolism
Breast Neoplasms
[SDV.CAN]Life Sciences [q-bio]/Cancer
Asymptomatic
Breast Neoplasms
Male
Dominique Farge
Fibrin Fibrinogen Degradation Products
03 medical and health sciences
[SDV.CAN] Life Sciences [q-bio]/Cancer
Double-Blind Method
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Internal medicine
Correspondence
Humans
Radiology
Nuclear Medicine and imaging
Autoimmune and Vascular Diseases
venous
business.industry
Case-control study
Ultrasonography
Doppler
thromboembolism
medicine.disease
equipment and supplies
Surgery
Carcinoma
Lobular
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
Case-Control Studies
Asymptomatic Diseases
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
Zdroj: Cancer Medicine
Cancer Medicine, Wiley, 2017, ⟨10.1002/cam4.1201⟩
Cancer Medicine, 2017, ⟨10.1002/cam4.1201⟩
ISSN: 2045-7634
DOI: 10.1002/cam4.1201⟩
Popis: International audience; Previous epidemiologic studies investigating central venous catheter (CVC)-related venous thromboembolism (CRT) were conducted in heterogenous cancer populations and data in breast cancer (BC) remain limited. To investigate the Doppler ultrasound (DUS)-CRT incidence, risk factors and outcomes in BC, we designed a prospective, multicenter cohort of nonmetastatic invasive BC patients undergoing insertion of a CVC for chemotherapy. All patients underwent double-blind DUS before, 7, 30, and 90 days after CVC insertion and a 6 months clinical follow-up. Symptomatic DUS-CRT were treated by anticoagulants. D-Dimers, thrombin generation, and platelet-derived microparticles were measured before and 2 days after CVC placement. In DUS-CRT patients, a nested case–control study analyzed the role of thrombophilia. Among 524 patients, the DUS-CRT (14 symptomatic, 46 asymptomatic) cumulative probability was 9.6% at 3 months and 11.5% at 6 months (overall incidence rate: 2.18/100 patient-months). Ten/14 symptomatic DUS-CRT were detected on double-blind DUS before the clinical symptoms, and 3/14 had a simultaneous pulmonary embolism. No clinical thrombotic event subsequently occurred in untreated asymptomatic DUS-CRT. Age >50 years (OR, 1.80; 95% CI, 1.01–3.22), BMI >30 kg/m² (OR, 2.64; 95% CI, 1.46–4.76) and comorbidities (OR, 2.05; 95% CI, 1.18–3.56) were associated with DUS-CRT. No biomarkers was found to predict DUS-CRT. In multivariate analysis, BMI >30 kg/m² (OR, 2.66; 95%CI, 1.46–4.84) and lobular carcinoma histology (OR, 2.56; 95%CI, 1.32–4.96) remained the only significant DUS-CRT risk factors. Thrombophilia did not account for DUS-CRT. Only clinical parameters identified high risk DUS-CRT patients who may be considered for thromboprophylaxis.
Databáze: OpenAIRE
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