OCCULT CANCER IN PATIENTS WITH VENOUS THROMBOEMBOLISM - WHICH PATIENTS, WHICH CANCERS

We have previously demonstrated that patients with idiopathic venous t hromboembolism (VTE) have a higher frequency of underlying cancer, Now we present a retrospective analysis of our 5-year experience with a s eries of 674 consecutive otherwise healthy patients, and a more restri cted battery of diagnostic tests. Occult cancer was found in 15 patien ts during admission. The diagnostic tools which led to suspect occult cancer were: abdominal CT-scan (4 patients); high carcinoembryonic lev els (2 patients); and high prostate-specific antigen levels (9 patient s). Eight further patients were diagnosed of cancer after discharge. C ancer was more commonly found in patients with idiopathic VTE: 13/105 patients (12%) versus 10/569 patients (2%); p <0.01; O. R.: 7.9 (95% C I: 3.14-20.09). During the same period of time we diagnosed VTE in 147 patients with previously known cancer. When overall considered. VTE w as the first sign of malignancy in most patients with prostatic and pa ncreatic carcinoma. On the contrary, most patients with breast, lung, uterine and brain cancers developed VTE as a terminal event of the dis ease. At variance with VTE patients and previously known cancer, most patients with occult malignancy were at an early stage. Further studie s are needed to confirm wi;ether patients with idiopathic VTE could be nefit from screening for occult cancer. Meanwhile, our findings may se rve as guidelines for physicians in this field.