Publication: Análisis del score de Khorana y predictores genómicos de riesgo de enfermedad tromboembólica venosa en pacientes tratados con quimioterapia en un medio extrahospitalario
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2017-10-02
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Universidad Complutense de Madrid
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Abstract
La enfermedad tromboembólica venosa (ETV) es una de las principales causas de morbi-mortalidad en los pacientes con cáncer en el momento actual. Datos recientes del grupo de Khorana et al. describen la enfermedad tromboembólica, incluyendo ETV y enfermedad tromboembólica arterial, como la segunda causa de muerte en los pacientes con cáncer (después del propio tumor). Los pacientes con cáncer activo tienen 4-7 veces más riesgo de padecer ETV sintomática en comparación con la población general. Es difícil determinar la incidencia real de enfermedad tromboembólica en los pacientes oncológicos debido a la gran heterogeneidad de la población. Esta incidencia puede variar de forma importante según distintos factores de riesgo (dependientes del paciente, cáncer y tratamiento) y oscilar entre 0,6-35%. Los tumores que se han asociado con el mayor riesgo de padecer un evento tromboembólico venoso son: cáncer de páncreas, estómago y tumores cerebrales. La incidencia de ETV asociada al cáncer parece haberse incrementado en las últimas dos décadas, especialmente en el subgrupo de pacientes que reciben quimioterapia en un medio ambulatorio. Diversos factores se han relacionado con este incremento: mejora de las técnicas de imagen, incorporación de nuevas drogas con alta trombogenicidad, aumento de la supervivencia de los pacientes con cáncer y concienciación por parte de los especialistas médicos implicados en el manejo de los pacientes oncológicos...
Venous thromboembolism (VTE) is a common event in cancer patients and one of the major causes of cancer-associated mortality and a leading cause of morbidity. In recent years, the incidence rates of VTE have notably increased; however, VTE is still commonly underestimated and certainly not considered for prophylaxis by oncologists. The risk of VTE is estimated to be fourfold higher in cancer patients compared with non-cancer patients. The true incidence of VTE in cancer patients remains uncertain, with reported incidence rates ranging from 0.8 % to over 30 % in some populations, and depends on several factors (tumor, host and treatment-related factors). Cancer patients with VTE have an increased incidence of VTE recurrence and anticoagulant-related bleeding complications compared with patients without cancer. VTE has been found to be an adverse prognosis factor in all stages of cancer. In the last decade it was postulated that the aggressiveness of a malignant tumor is clearly correlated to the incidence of VTE. Chemotherapy has been identified as an independent risk factor for VTE...
Venous thromboembolism (VTE) is a common event in cancer patients and one of the major causes of cancer-associated mortality and a leading cause of morbidity. In recent years, the incidence rates of VTE have notably increased; however, VTE is still commonly underestimated and certainly not considered for prophylaxis by oncologists. The risk of VTE is estimated to be fourfold higher in cancer patients compared with non-cancer patients. The true incidence of VTE in cancer patients remains uncertain, with reported incidence rates ranging from 0.8 % to over 30 % in some populations, and depends on several factors (tumor, host and treatment-related factors). Cancer patients with VTE have an increased incidence of VTE recurrence and anticoagulant-related bleeding complications compared with patients without cancer. VTE has been found to be an adverse prognosis factor in all stages of cancer. In the last decade it was postulated that the aggressiveness of a malignant tumor is clearly correlated to the incidence of VTE. Chemotherapy has been identified as an independent risk factor for VTE...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 13-01-2016