Venous thromboembolism in patients with breast, ovarian, and uterine cancer. A comparative analysis from the Registro Informatizado Enfermedad TromboEmbólica registry
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: The risk of recurrent venous thromboembolism (VTE) and bleeding during anticoagulation may vary by the cancer type. Objectives: We assessed outcomes during anticoagulation in women with breast, ovarian, or uterine cancer and VTE. Methods: = 906) cancer and acute VTE. We assessed VTE recurrences, bleeding, and mortality according to cancer type and anticoagulant type. Multivariate Cox models were adjusted for age, metastases, anemia, renal function, and treatment at VTE onset. Results: Uterine cancer patients had the highest rates of major bleeding (11.1 per 100 patient-years) and fatal bleeding (1.07 per 100 patient-years), while ovarian cancer patients had the highest rate of VTE recurrences (7.29 per 100 patient-years). In contrast, breast cancer patients had the lowest event rates overall. Among low-molecular-weight heparin-treated patients, major bleeding was higher in uterine (6.37 per 100 patient-years) and ovarian (4.62 per 100 patient-years) cancer than breast cancer patients (1.89 per 100 patient-years). Direct oral anticoagulant use was associated with low recurrence rates in breast cancer (0.58 per 100 patient-years), but outcomes in uterine cancer remained less favorable. Multivariable models confirmed cancer-specific risks. Conclusions: VTE outcomes vary significantly by cancer type. Patients with uterine cancer face an elevated bleeding risk, potentially impacting anticoagulant continuity and contributing to VTE recurrence. These findings support the need for cancer-specific risk assessment and individualized anticoagulation strategies adapted to the specific cancer type.
Authors: Olga Gavín Sebastián, Javier Trujillo-Santos, María del Carmen Díaz-Pedroche, Pablo Demelo-Rodríguez, Sonia Otálora, Benjamin Brenner, José María Pedrajas, Alessandra Bura-Riviere, Luis Hernández-Blasco, Manuel Monreal, A. Abad-Fernández, M.D. Adarraga, J. Aibar, A. Alberich-Conesa, J. Alfonso, C. Amado, M. Angelina-García, J.I. Arcelus, A. Ballaz, R. Barba, C. Barbagelata, M. Barrón, B. Barrón-Andrés, F. Beddar-Chaib, Á. Blanco-Molina, C.S. Bonavila, R.F. Cantarella, L. Chasco, G. Claver, P. Crecente, J. Creu-Paris, J. Criado, C. De Juana-Izquierdo, J. Del Toro, P. Demelo-Rodríguez, M.C. Díaz-Pedroche, J.A. Díaz-Peromingo, Á. Dubois-Silva, D. Durán, J.C. Escribano, C. Falgá-Tirado, L.A. Fernández-Bermejo, C. Fernández-Capitán, J.L. Fernández-Reyes, M.Á. Fidalgo, I. Francisco, C. Gabara, F. Galeano-Valle, F. García-Bragado, E. García-Coya, A. García-Ortega, O. Gavín-Sebastián, A. Gil-Díaz, C. Gómez-Cuervo, A. González-Munera, J. González-Olmedo, I. Gorostidi-Álvarez, J. Gorostidi-Pérez, L. Guirado, J. Gutiérrez-Guisado, C. Heredia-Mena, L. Hernández-Blasco, J. Hernández-Borge, M.J. Hernández-Vidal, P. Huélamo-López, D. Jiménez, I. Jou, M.D. Joya, J. Lagullón-Sabariego, R. Lecumberri, P. Llamas, L. López-Jiménez, P. López-Miguel, J.J. López-Núñez, A. López-Ruiz, J.B. López-Sáez, A. Lorenzo, A. Maestre, P.J. Marchena, M. Marcos, R. Marín-Baselga, M. Martín-del Pozo, M. Melero, M.I. Mercado, J. Moisés-Lafuente, M. Monreal, L. Monzón, S. Moreno-Casas, A. Moreno-Fernández, M.S. Navas, J.A. Nieto, M.J. Núñez-Fernández, M. Olid, M.C. Olivares, L. Ordieres-Ortega, M. Ortiz, J. Osorio, S. Otálora, E.M. Padín-Paz, J. Pagán, P. Parra-Caballero, P. Parra-Rosado, B. Payró-Bisart, J.M. Pedrajas, C. Pérez-Ductor, M. Pérez-Pinar, M.L. Peris, M.L. Pesce, J.A. Porras, L.M. Prieto-Gañán, G. Puche, A. Rivas, F. Rivera-Cívico, A. Rivera-Gallego, M. Roca, A. Rodríguez-Cobo, P. Ruiz-Artacho, N. Ruiz-Giménez, G. Salgueiro, T. Sancho, V. Sendín, G. Sierra-Palomares, P. Sigüenza, A. Solé, S. Soler, S. Suárez-Fernández, A. Suárez-Simón, R. Tirado, M.R. Toda, C. Tolosa, J. Trujillo-Santos, Y. Tung-Chen, F. Uresandi, R. Valle, J.F. Varona, E. Vázquez, E. Vega-Romero, D. Vicente-Navarro, G. Vidal, P. Villares, J.S. You, C. Ay, S. Nopp, I. Pabinger, Q. Van Thillo, P. Verhamme, A. Verstraete, A.T. Rocha, H.H.B. Yoo, C.A. Jiménez-Echandía, A.C. Montenegro, J. Roa, P. Grenar, J. Hirmerova, R. Malý, S. Accassat, L. Bertoletti, A. Bura-Riviere, J. Catella, R. Chopard, F. Couturaud, O. Espitia, R. Le Mao, B. Leclercq, I. Mahé, F. Moustafa, L. Plaisance, G. Poenou, I. Quéré, G. Sarlon-Bartoli, P. Suchon, E. Versini E, S. Schellong, Y. Jenab, A. Khodayari, A. Mohammadzadeh, B. Mohebbi, F. Rashidi, P. Sadeghipour, S. Yadangi, B. Brenner, N. Dally, I. Tzoran, M. Basaglia, F. Bilora, D. Bissacco, C. Bortoluzzi, M. Bortoluzzi, B. Brandolin, R. Casana, M.M. Ciammaichella, P. Di Micco, E. Imbalzano, D. Lambertenghi-Deliliers, S. Marino, D. Mastroiacovo, R. Pesavento, V. Pizzuti, P. Prandoni, T. Scandiuzzi-Piovesan, P. Scarinzi, C. Siniscalchi, A. Visonà, N. Vo Hong, H. Cesnieks, R. Kaulins, A. Skride, L.F. Hernández-Rivera, M.Á. Mendoza Romo-Ramírez, M. Molina-Avilés, Z. Tazi-Mezalek, S. Fonseca, C. Fontes, J. Meireles, B. Soeiro, M. Bosevski, H. Stojmirska, S. Barco, L. Mazzolai, D.J. Angiolillo, J.A. Caprini, L. Ortega-Paz, A.J. Tafur, H.M. Bui, S.T. Nguyen, K.Q. Pham, G.B. Tran
Institutions: Hospital Clínico Universitario Lozano Blesa, Santa Lucía University General Hospital, Universidad Católica de Murcia, Hospital Universitario 12 De Octubre, Hospital General Universitario Gregorio Marañón, Hospital Universitario Virgen de la Arrixaca, Rambam Health Care Campus, Hospital Clínico San Carlos, Hôpital Rangueil, Hospital General Universitario de Alicante Doctor Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Centro de Investigación Biomédica en Red
Language: English
Subfield: Internal Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,250
Funders: Sanofi, Universidad Autónoma de Madrid
OpenAlex ID: W4417443670