VENOUS THROMBOSIS AND CANCER - EVALUATION OF VENOUS THROMBOEMBOLISM RISK-FACTORS

In medical patients, risk factors of leg venous thrombosis are not wel l evaluated. Cancer is considered as an important one. The aim of this study was to evaluate the role of intrinsic thrombotic risk (tumor hy percoagulable state) and external thrombotic risk (associate factors). We have made a prospective analysis of thrombotic venous risk factors in two medical populations with leg venous thrombosis : patients with cancer and patients without cancer. Risk of thrombosis depends on the thrombogenic importance of the risk factor and its chronicity or net. We assessed cancer and thromboembolic disease at the time of diagnosi s and during a median follow up of 125.2 days, We included 31 consecut ive cases of cancer (21 men, 10 women, mean age 63.8 years), and 50 co nsecutive cases of non cancer patients (32 men, 18 women, mean age 65. 5 years), these two populations were not different. The classic risk f actors of venous thrombosis were not frequent in cancer patient. Analy sis of thrombotic risk showed that 61 % of cancer patient group had ve nous thrombosis without classic thrombotic risk, as compared to 32 % i n non cancer patient group, showing the direct role of cancer in throm bosis (p < 0,01). The cancer was often aggressive and metastatic adeno carcinoma of various origins. The effect of chimiotherapy is not clear , only hormonotherapy seemed to be responsible in two cases. Cancer hy percoagulability, defined by clinical caracteristics, is a real risk f actor of venous thrombosis but of low frequency. Indeed, the incidence of venous thrombosis in oncologic unit is rare (0.4 %). Finally, thro mboembolic disease in cancer patients is not different than in no canc er patients, Trousseau's syndrome is unfrequent. Prognosis is poor (40 % death with 44.5 days of median survival), and antithrombotic therap y complications are frequent (bleeding 16 %, oral anticoagulants resis tance 20 %).