OUTCOME OF PATIENTS WITH ADVANCED NEOPLASTIC DISEASE RECEIVING VENA-CAVAL FILTERS

PURPOSE: The authors examined the appropriateness and outcome of infer ior vena caval (NC) filter placements in patients with advanced malign ancies and limited expected survival. PATIENTS AND METHODS: Over a 35- month period, 35 IVC filters were inserted in 34 adult patients with a dvanced neoplasms, Follow-up was as long as 28 months (mean, 5.2 month s), Filter effectiveness, complications, recurrent pulmonary emboli, p atient survival, and hospital discharge status were recorded. RESULTS: Twenty-eight patients (82%) were discharged home (n = 21) or to nursi ng facilities (n = 7) between 1 and 193 days (mean, 23 days) after fil ter insertion, Six patient (18%) died during hospitalization 1-95 days after filter insertion, The overall mean survival was 6.6 months; for patients with stage III and IV tumors mean survival was 8.0 and 5.5 m onths, respectively, Even among patients with stage TV disease, 59% su rvived longer than 3 months, There were no complications related to fi lter insertion and no clinical evidence of recurrent pulmonary emboli, In 14% of patients, filters enabled invasive therapeutic and palliati ve procedures to be performed. CONCLUSION: The presence of advanced ne oplastic disease by itself should not be a deterrent to insertion of I VC filters, as most patients survived well beyond initial hospitalizat ion.