Patient characteristics and long-term outcomes beyond the first 6 months after a diagnosis of cancer-associated thrombosis.

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10057 Background: Cancer associated thrombosis (CAT) is a common complication of malignancies. However, little is known about the clinical course of CAT beyond the initial treatment period of 3 to 6 months. This information is important for clinicians and patients to inform their decision regarding duration of anticoagulation. Methods: Health records from 523 consecutive patients managed at the Vancouver General Hospital Thrombosis clinic for CAT (excluding catheter-related thrombosis) between 2013 and 2015 were reviewed; 327 were alive at 6 months post initial CAT diagnosis. Patient and cancer characteristics, objectively documented recurrent venous thromboembolism (rVTE), clinically relevant bleeding (CRB), and overall mortality of this “survivor” cohort over month 6 to 24 are described. Results: In the 6 month survivor cohort, patients were followed for a median of 605 days (range 1 to 730) and 85.9% had at least 24 months of follow-up or died. Patient characteristics at at 6 months are summarized (Table). Anticoagulation was continued in 68.8%, with a median duration of 93 days; 54.3% of patient-days were on anticoagulation. In the 6 to 24 months after the initial CAT diagnosis, there were 34 rVTE in 30 patients (9.2%; 95% CI 6.3 - 12.8) and 16 CRB in 14 (4.3%; 95% CI 2.4 – 7.1) patients, corresponding to 2.9 rVTE per 100 patient-days and 1.4 CRB per 100 patient-days of follow-up. Twenty-one (61.8%) rVTE events and 11 CRB episodes (68.8%) occurred on therapeutic anticoagulation. Over the 18 months, 141 (43.1%; 95%CI 37.7 – 48.7) patients died. Causes of death were cancer (80.9%), rVTE (1.4%), bleeding (2.8%), other (7.8%), and unknown (7.1%). Three fatal bleeds and 2 fatal rVTE occurred while on anticoagulation. Conclusions: Patients with CAT who are alive at 6 months after VTE diagnosis remain at high risk of rVTE, CRB and death. Patient characteristics at 6 months after initial CAT diagnosis Median Age, year 63.8 Male, % 48.3 ≥2 comorbidities, % 25.1 Cancer Site, % Upper GI 13.5 Hematologic 19.3 Lower GI 15.0 Lung 12.8 Gynecological 13.8 Breast 7.3 GU 4.3 Prostate 4.9 Brain 3.4 Other 5.8 Metastatic disease,* % 56.0 Cancer treatment, % 64.7 *among patients with solid tumours (n = 259).

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