Current Oncology (Aug 2022)

Risk for Arterial Thromboembolic Events (ATEs) in Patients with Advanced Urinary Tract Cancer (aUTC) Treated with First-Line Chemotherapy: Single-Center, Observational Study

  • Aristotelis Bamias,
  • Kimon Tzannis,
  • Roubini Zakopoulou,
  • Minas Sakellakis,
  • John Dimitriadis,
  • Alkistis Papatheodoridi,
  • Loukianos Rallidis,
  • Panagiotis Halvatsiotis,
  • Anna Tsiara,
  • Maria Kaparelou,
  • Efthymios Kostouros,
  • Despina Barbarousi,
  • Konstantinos Koutsoukos,
  • Evangelos Fragiadis,
  • Athanasios E. Dellis,
  • Ioannis Anastasiou,
  • Konstantinos Stravodimos,
  • Alexandros Pinitas,
  • Athanasios Papatsoris,
  • Ioannis Adamakis,
  • Ioannis Varkarakis,
  • Charalampos Fragoulis,
  • Stamatina Pagoni,
  • Charis Matsouka,
  • Andreas Skolarikos,
  • Dionysios Mitropoulos,
  • Konstantinos Doumas,
  • Charalampos Deliveliotis,
  • Constantinos Constantinides,
  • Meletios-Athanasios Dimopoulos

DOI
https://doi.org/10.3390/curroncol29090478
Journal volume & issue
Vol. 29, no. 9
pp. 6077 – 6090

Abstract

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Arterial thromboembolism has been associated with cancer or its treatment. Unlike venous thromboembolism, the incidence and risk factors have not been extensively studied. Here, we investigated the incidence of arterial thromboembolic events (ATEs) in an institutional series of advanced urinary tract cancer (aUTC) treated with cytotoxic chemotherapy. The ATE definition included peripheral arterial embolism/thrombosis, ischemic stroke and coronary events. A total of 354 aUTC patients were analyzed. Most patients (95.2%) received platinum-based chemotherapy. A total of 12 patients (3.4%) suffered an ATE within a median time of 3.6 months from the start of chemotherapy. The most frequent ATE was ischemic stroke (n = 7). Two ATEs were fatal. The 6-month and 24-month incidence were 2.1% (95% confidence interval [CI]: 0.9–4.1) and 3.6% (95% CI: 1.9–6.2), respectively. Perioperative chemotherapy increased the risk for ATE by 5.55-fold. Tumors other than UTC and pure non-transitional cell carcinoma histology were also independent risk factors. No association with the type of chemotherapy was found. Overall, ATEs occur in 4.6% of aUTC patients treated with chemotherapy and represent a clinically relevant manifestation. Perioperative chemotherapy significantly increases the risk for ATE. The role of prophylaxis in high-risk groups should be prospectively studied.

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