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14-04-2010 | Cardiology | Article

VTE risk highlighted in prostate cancer patients


Free abstract

MedWire News: Men with prostate cancer have an increased risk for venous thromboembolism (VTE) that should be taken into account when managing prostate cancer patients, especially those receiving endocrine therapy, study findings suggest.

Mieke van Hemelrijck, from King’s College London in the UK, and colleagues examined data from PCBaSE Sweden, which is based on the National Prostate Cancer Register of Sweden, the Hospital Discharge Register, and the Cause of Death Register. They compiled data on 76,600 men diagnosed with prostate cancer between 1997 and 2007 and compared them with the overall Swedish male population.

In all, 30,642 prostate cancer patients received primary endocrine therapy, 26,432 patients received curative treatment, and 19,526 patients were placed on surveillance. Patients who received endocrine therapy were more likely to be older, and were less likely to have localized tumors and low prostate-specific antigen concentrations than patients in other treatment groups.

VTE occurred in 1881 patients, consisting of 767 men with deep vein thrombosis (DVT), 873 with pulmonary embolism (PE), and 241 with arterial embolism, the team notes in the journal Lancet Oncology.

Compared with the general male population, the risks for DVT and PE were increased in patients receiving endocrine therapy, at standardised incidence ratios (SIRs) of 2.48 and 1.95, but the risk for arterial embolism was not increased, at an SIR of 1.00. These findings were replicated in patients receiving curative treatment, at SIRs of 1.73, 2.03, and 0.95, respectively, and in those on surveillance, at SIRs of 1.27, 1.57, and 1.08, respectively.

The team writes: “Our findings indicate that it is important to consider thromboembolic side effects when treating patients with prostate cancer, especially those who require endocrine treatment.”

In an accompanying comment, Philip Saylor and Annemarie Fogerty, from Massachusetts General Hospital Cancer Center in Boston, the USA, say: “The data should increase clinical suspicion for VTE in men with prostate cancer and stimulate further study of the potential interactions between androgen deprivation and blood coagulation.”

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