INFERIOR VENA-CAVA FILTERS IN CANCER-PATIENTS - INDICATIONS AND OUTCOME

Purpose: Our experience with inferior vena cava (IVC) filter placement to prevent pulmonary emboli (PE) in cancer patients with deep vein th romboses (DVT) was reviewed to identify indications, patient character istics, complications, and long-term outcome. Methods: Charts of 182 p atients with cancer were retrospectively analyzed. All patients had re ceived an IVC filter in our institution between January 1980 and April 1992. Results: Of 182 patients, 103 were men and 79 were women. Media n age was 59 years (range, 15 to 88). Eight patients (4%) had stage I disease, 22 patients (12%) stage II, 37 patients (20%) stage III, and 115 patients (63%) stage IV. A DVT was diagnosed in 97 patients (53%), a PE in 46 patients (25%), and a combination in 39 patients (21%). In dications for IVC filter placement were DVT or PE in the presence of c ontraindications to anticoagulation therapy (perioperative, n = 58; CN S metastases, n = 20; thrombocytopenia, n = 7; bleeding, n = 61; other s, n = 24; total, N = 170) or anticoagulation failure (recurrent PE, n = 6; recurrent DVT; n = 6; total N = 12). Filter placement complicati ons (0 = 6, 3%) included malposition (n = 3), migration (n = 1), arrhy thmia (n = 1), and wound infection (n = 1), but no deaths. After filte r placement, four patients developed a recurrent PE, and 11 patients d eveloped a recurrent DVT. No significant postthrombotic complications were observed. Conclusion: IVC filter placement patients with advanced cancer and thrombotic complications is safe, well tolerated, and con offer effective therapy/prophylaxis with a low incidence of treatment failure. (C) 1996 by American Society of Clinical Oncology.