Rate of thromboembolic events in mesothelioma

Thromboembolic event (TEE) rates in the general population and the cancer population are 0.1% to 2% and 10% to 15%, respectively. Our clinical observation is that mesothelioma patients are very susceptible to TEE, including arterial thromboses, but the TEE incidence has not been reported. This retrospective study attempts to determine the rates of TEE in patients with mesothelioma.

Three hundred seventy-four patients with mesothelioma were identified through the New Mexico SEER database. Sixty-five of them were included in the University of New Mexico tumor registry from 1973 to 2003. Documented TEE rates were abstracted from the patient charts. Chi-square test, Fisher's exact test, and logistic regression were used to identify potentially associated prognostic factors.

Fifty-four medical records were reviewed. Patients had a median of six visits (range, 1 to 63 visits). Median age was 60 years (range, 29 to 79 years). Sex distribution was 11 women and 43 men. Anatomic locations of the primary tumor were 35 pleural, 17 peritoneal, 1 pericardial, and 1 pericardial or pleural mesothelioma. The TEE rate was 27.7% (15 of 54), including 10 deep venous thromboses, 2 arterial clots, 2 myocardial infarctions, and 1 pulmonary embolus. No association between the development of TEE and any known prognostic factors were observed.

The 27.7% TEE incidence rate in mesothelioma patients is higher than in other cancer patients. The true incidence of TEE in mesothelioma is likely to be higher than the rate observed in our review, owing to the retrospective nature of the data. Prophylactic anticoagulation trials are recommended to determine the prevention benefit in this high-risk population.