Hypoalbuminemia for the prediction of venous thromboembolism and treatment of direct oral anticoagulants in metastatic gastric cancer patients

Kotoe Takayoshi, Hitoshi Kusaba, Tomomi Aikawa, Sakuya Koreishi, Kosuke Sagara, Michitaka Nakano, Masato Komoda, Mihoko Kono, Mitsuhiro Fukata, Takeshi Arita, Taito Esaki, Koichi Akashi, Eishi Baba

研究成果: ジャーナルへの寄稿記事

抄録

Background: Venous thromboembolism (VTE) is highly associated with advanced gastric cancer (AGC) and is sometimes lethal. Predictors of VTE have not been identified, and the efficacy and safety of direct oral anticoagulants (DOACs) for AGC-associated VTE remain to be clarified. Methods: A total of 188 AGC patients who started chemotherapy during the period from January 2014 to December 2017 in our institutions were retrospectively examined for the incidence of VTE, risk factors for VTE, and the efficacy and safety of DOAC-based anticoagulant therapy for VTE. Results: Thirty-four patients (18%) were diagnosed with VTE at the start or during the course of chemotherapy (VTE group). More VTE group patients had a history of abdominal surgery and had moderate–severe ascites (32% versus 17%, 32% versus 14%, respectively) than non-VTE group patients (NVTE group). The mean serum albumin concentrations in the VTE group were significantly lower than NVTE group (3.38 mg/dL vs 3.65 mg/dL, respectively). Multivariate analysis showed that hypoalbuminemia was significantly correlated with VTE (P = 0.012). In the VTE group, 29 patients (85%) received anticoagulant therapy, including 24 patients treated with DOACs. No lethal VTE was observed in any patients. Thirteen patients (45%) terminated DOACs because of anemia or bleeding events, of whom eleven developed major bleeding. Median overall survivals of the VTE and NVTE groups were 9.63 months and 11.5 months, respectively (P = 0.262). Conclusion: Hypoalbuminemia appears to be a risk factor for AGC-associated VTE. DOACs are effective to AGC-associated VTE, but careful observation of bleeding events is required.

元の言語英語
ページ(範囲)988-998
ページ数11
ジャーナルGastric Cancer
22
発行部数5
DOI
出版物ステータス出版済み - 9 5 2019

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Hypoalbuminemia
Venous Thromboembolism
Anticoagulants
Stomach Neoplasms
Therapeutics
Hemorrhage
Safety
Drug Therapy
Thromboembolism

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology
  • Cancer Research

これを引用

Hypoalbuminemia for the prediction of venous thromboembolism and treatment of direct oral anticoagulants in metastatic gastric cancer patients. / Takayoshi, Kotoe; Kusaba, Hitoshi; Aikawa, Tomomi; Koreishi, Sakuya; Sagara, Kosuke; Nakano, Michitaka; Komoda, Masato; Kono, Mihoko; Fukata, Mitsuhiro; Arita, Takeshi; Esaki, Taito; Akashi, Koichi; Baba, Eishi.

:: Gastric Cancer, 巻 22, 番号 5, 05.09.2019, p. 988-998.

研究成果: ジャーナルへの寄稿記事

Takayoshi, Kotoe ; Kusaba, Hitoshi ; Aikawa, Tomomi ; Koreishi, Sakuya ; Sagara, Kosuke ; Nakano, Michitaka ; Komoda, Masato ; Kono, Mihoko ; Fukata, Mitsuhiro ; Arita, Takeshi ; Esaki, Taito ; Akashi, Koichi ; Baba, Eishi. / Hypoalbuminemia for the prediction of venous thromboembolism and treatment of direct oral anticoagulants in metastatic gastric cancer patients. :: Gastric Cancer. 2019 ; 巻 22, 番号 5. pp. 988-998.
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title = "Hypoalbuminemia for the prediction of venous thromboembolism and treatment of direct oral anticoagulants in metastatic gastric cancer patients",
abstract = "Background: Venous thromboembolism (VTE) is highly associated with advanced gastric cancer (AGC) and is sometimes lethal. Predictors of VTE have not been identified, and the efficacy and safety of direct oral anticoagulants (DOACs) for AGC-associated VTE remain to be clarified. Methods: A total of 188 AGC patients who started chemotherapy during the period from January 2014 to December 2017 in our institutions were retrospectively examined for the incidence of VTE, risk factors for VTE, and the efficacy and safety of DOAC-based anticoagulant therapy for VTE. Results: Thirty-four patients (18{\%}) were diagnosed with VTE at the start or during the course of chemotherapy (VTE group). More VTE group patients had a history of abdominal surgery and had moderate–severe ascites (32{\%} versus 17{\%}, 32{\%} versus 14{\%}, respectively) than non-VTE group patients (NVTE group). The mean serum albumin concentrations in the VTE group were significantly lower than NVTE group (3.38 mg/dL vs 3.65 mg/dL, respectively). Multivariate analysis showed that hypoalbuminemia was significantly correlated with VTE (P = 0.012). In the VTE group, 29 patients (85{\%}) received anticoagulant therapy, including 24 patients treated with DOACs. No lethal VTE was observed in any patients. Thirteen patients (45{\%}) terminated DOACs because of anemia or bleeding events, of whom eleven developed major bleeding. Median overall survivals of the VTE and NVTE groups were 9.63 months and 11.5 months, respectively (P = 0.262). Conclusion: Hypoalbuminemia appears to be a risk factor for AGC-associated VTE. DOACs are effective to AGC-associated VTE, but careful observation of bleeding events is required.",
author = "Kotoe Takayoshi and Hitoshi Kusaba and Tomomi Aikawa and Sakuya Koreishi and Kosuke Sagara and Michitaka Nakano and Masato Komoda and Mihoko Kono and Mitsuhiro Fukata and Takeshi Arita and Taito Esaki and Koichi Akashi and Eishi Baba",
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pages = "988--998",
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TY - JOUR

T1 - Hypoalbuminemia for the prediction of venous thromboembolism and treatment of direct oral anticoagulants in metastatic gastric cancer patients

AU - Takayoshi, Kotoe

AU - Kusaba, Hitoshi

AU - Aikawa, Tomomi

AU - Koreishi, Sakuya

AU - Sagara, Kosuke

AU - Nakano, Michitaka

AU - Komoda, Masato

AU - Kono, Mihoko

AU - Fukata, Mitsuhiro

AU - Arita, Takeshi

AU - Esaki, Taito

AU - Akashi, Koichi

AU - Baba, Eishi

PY - 2019/9/5

Y1 - 2019/9/5

N2 - Background: Venous thromboembolism (VTE) is highly associated with advanced gastric cancer (AGC) and is sometimes lethal. Predictors of VTE have not been identified, and the efficacy and safety of direct oral anticoagulants (DOACs) for AGC-associated VTE remain to be clarified. Methods: A total of 188 AGC patients who started chemotherapy during the period from January 2014 to December 2017 in our institutions were retrospectively examined for the incidence of VTE, risk factors for VTE, and the efficacy and safety of DOAC-based anticoagulant therapy for VTE. Results: Thirty-four patients (18%) were diagnosed with VTE at the start or during the course of chemotherapy (VTE group). More VTE group patients had a history of abdominal surgery and had moderate–severe ascites (32% versus 17%, 32% versus 14%, respectively) than non-VTE group patients (NVTE group). The mean serum albumin concentrations in the VTE group were significantly lower than NVTE group (3.38 mg/dL vs 3.65 mg/dL, respectively). Multivariate analysis showed that hypoalbuminemia was significantly correlated with VTE (P = 0.012). In the VTE group, 29 patients (85%) received anticoagulant therapy, including 24 patients treated with DOACs. No lethal VTE was observed in any patients. Thirteen patients (45%) terminated DOACs because of anemia or bleeding events, of whom eleven developed major bleeding. Median overall survivals of the VTE and NVTE groups were 9.63 months and 11.5 months, respectively (P = 0.262). Conclusion: Hypoalbuminemia appears to be a risk factor for AGC-associated VTE. DOACs are effective to AGC-associated VTE, but careful observation of bleeding events is required.

AB - Background: Venous thromboembolism (VTE) is highly associated with advanced gastric cancer (AGC) and is sometimes lethal. Predictors of VTE have not been identified, and the efficacy and safety of direct oral anticoagulants (DOACs) for AGC-associated VTE remain to be clarified. Methods: A total of 188 AGC patients who started chemotherapy during the period from January 2014 to December 2017 in our institutions were retrospectively examined for the incidence of VTE, risk factors for VTE, and the efficacy and safety of DOAC-based anticoagulant therapy for VTE. Results: Thirty-four patients (18%) were diagnosed with VTE at the start or during the course of chemotherapy (VTE group). More VTE group patients had a history of abdominal surgery and had moderate–severe ascites (32% versus 17%, 32% versus 14%, respectively) than non-VTE group patients (NVTE group). The mean serum albumin concentrations in the VTE group were significantly lower than NVTE group (3.38 mg/dL vs 3.65 mg/dL, respectively). Multivariate analysis showed that hypoalbuminemia was significantly correlated with VTE (P = 0.012). In the VTE group, 29 patients (85%) received anticoagulant therapy, including 24 patients treated with DOACs. No lethal VTE was observed in any patients. Thirteen patients (45%) terminated DOACs because of anemia or bleeding events, of whom eleven developed major bleeding. Median overall survivals of the VTE and NVTE groups were 9.63 months and 11.5 months, respectively (P = 0.262). Conclusion: Hypoalbuminemia appears to be a risk factor for AGC-associated VTE. DOACs are effective to AGC-associated VTE, but careful observation of bleeding events is required.

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U2 - 10.1007/s10120-019-00930-2

DO - 10.1007/s10120-019-00930-2

M3 - Article

VL - 22

SP - 988

EP - 998

JO - Gastric Cancer

JF - Gastric Cancer

SN - 1436-3291

IS - 5

ER -