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A6419 - Contemporary Incidence Rates of Venous Thromboembolism in Patients with Non-Small Cell Lung Cancer
Author Block: D. C. Escobar Olaya1, N. Meti2, G. Kasymjanova3, V. Cohen4, J. Agulnik3, D. Small3, A. Kezouh5, V. Tagalakis6; 1Centre for Clinical Epidemiology, Lady Davis Institute, Montreal, QC, Canada, 2Medicine, McGill University, Jewish General Hospital, Montreal, QC, Canada, 3Pulmonary, Jewish General Hospital, Montreal, QC, Canada, 4Oncology, Jewish General Hospital, Montreal, QC, Canada, 5Centre of Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada, 6General Internal Medicine, Center for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.
Background: The landscape of non-small lung cancer (NSCLC) therapies has rapidly evolved over the past few years. As a result, we determined contemporary incidence rates of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE) in a single center cohort of patients with NSCLC.Methods: Using the pulmonary oncology database of the Peter Brodje Lung Cancer Centre of the Jewish General Hospital, Montreal, Canada, we identified all consecutive individuals with newly diagnosed lung cancer confirmed via pathological or histological tissue diagnosis, without a concurrent diagnosis of VTE at the time of the lung cancer diagnosis between January 1st, 2009 and August 31st, 2016. Date of cohort entry was the cancer diagnosis, and patients were followed until the earliest of VTE diagnosis, death, loss to follow up, or end of study (August 31st, 2016). We ascertained the occurrence of an objectively defined DVT and PE. Data on patient-specific factors (age, gender), cancer-specific factors (tumor type, stage), treatment specific (surgery, radiotherapy, chemotherapy type, targeted therapy type) was collected and compared among patients with and without VTE.Results: Of the 489 NSCLC patients included in the cohort, 84 (17.2 %) patients developed an objectively confirmed VTE. The median follow-up was 1.48 years. The VTE incidence rate was 176.6 per 1000 person-years (p-y) in the first 30 days following cancer diagnosis and peaked at 406.5 per 1000 p-y in the 31-60 days post-diagnosis. During the second-year post-diagnosis, the rate decreased to 30.6 per 1000 p-y (95% CI 17.8-52.7). The 6-month and 1-year cumulative VTE risk was 10% (95% confidence interval (CI) 7-13) and 16% (95% CI 13-20), respectively. Only advanced stage of disease, defined by stage IIIb and greater, was associated with VTE (adjusted Hazard Ratio 2.99 (95% CI 1.70-5.25)).Conclusion: The risk of VTE in patients with NSCLC remains high especially in the immediate period post-cancer diagnosis and in patients with advanced stage of the disease. Our data support targeted thromboprophylaxis studies in high-risk patients with NSCLC.