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Variación en los resultados del tromboembolismo venoso basado en el sitio del cáncer primario: un análisis del
Javier Trujillo-Santos1, Cihan Ay2, Behnood Bikdeli3
1Department of Internal Medicine, Hospital General Universitario Santa Lucía, Cartagena, Spain; UCAM - Universidad Católica San Antonio de Murcia, Guadalupe, Spain.
JACC. Advances
|August 23, 2025
Resumen
Los pacientes con cáncer con tromboembolismo venoso (TEV) tienen mayores riesgos de recurrencia y hemorragia, que difieren significativamente según el tipo de cáncer. Se recomiendan estrategias de anticoagulación personalizadas basadas en estos riesgos específicos del sitio.
Área de la Ciencia:
- En el campo de la oncología
- Hematología
- Investigación clínica
Sus antecedentes:
- Los pacientes con tromboembolismo venoso asociado al cáncer (TEV) tienen un riesgo elevado de recurrencia y hemorragia de TEV.
- El impacto de la localización del cáncer en estos riesgos no está bien definido.
Objetivo del estudio:
- Comparar los riesgos de 90 días de TEV recurrente o muerte relacionada con TEV y hemorragia mayor en varios sitios de cáncer.
- Informar estrategias personalizadas de anticoagulación para pacientes con cáncer con TEV.
Principales métodos:
- Análisis de 18.660 pacientes con cáncer activo y TEV del registro RIETE.
- Se utilizaron modelos multivariables de Cox y análisis de riesgos de competencia Fine-Gray.
- Los análisis de sensibilidad incluyeron el emparejamiento de la puntuación de propensión y la estratificación del subgrupo por sitio de cáncer.
Principales resultados:
- Los pacientes con trombosis asociada al cáncer presentaron un riesgo significativamente mayor de TEV (RH: 2,54) y de hemorragia mayor (RH: 1,40) en comparación con los pacientes sin cáncer.
- Los cánceres de pulmón y de páncreas mostraron el mayor riesgo trombótico, mientras que los cánceres gastrointestinales, genitourinarios y de páncreas tuvieron el mayor riesgo de sangrado.
- Los resultados fueron consistentes en todos los análisis de sensibilidad, incluido el emparejamiento de la puntuación de propensión.
Conclusiones:
- Los riesgos de tromboembolismo venoso y sangrado en pacientes con cáncer varían considerablemente según el sitio primario del cáncer.
- Estos hallazgos subrayan la necesidad de un tratamiento anticoagulante adaptado a cada tipo de cáncer.
Palabras clave:
el sangradotratamiento con anticoagulantesla mortalidadRecurrenciasTromboembolismo venosoMás Videos Relacionados
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