March 20, 2018
2 min read

Lower-limb arterial thrombosis may be marker of cancer

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Patients with lower-limb arterial thrombosis may be susceptible to development of cancer and, subsequently, cancer mortality, according to findings published in Circulation.

The connection between lower-limb arterial thrombosis and cancer was not known, so Jens Sundbøll, MD, PhD, from the department of clinical epidemiology at Aarhus University Hospital in Denmark, and colleagues analyzed 6,600 patients (53% men) from population-based Danish medical registries who were diagnosed with first-time lower-limb arterial thrombosis between 1994 and 2013.

The researchers compared the observed number of cancers to the expected number based on national incidence rates according to sex, age and calendar year.

To determine whether lower-limb arterial thrombosis was a predictor for all-cause mortality in patients with cancer, the researchers also analyzed 131,989 matched comparators with cancer but without lower-limb arterial thrombosis.

Median follow-up for patients with lower-limb arterial thrombosis was 2.7 years (interquartile range, 0.3-6.8). Median follow-up for comparators was 6.7 years (interquartile range, 2.5-10).

Among those with lower-limb arterial thrombosis, 772 developed cancer during the study period, with a 2.5% risk for any cancer at 6 months and a 17.9% risk for any cancer at 20 years, the researchers wrote.

The standardized incidence ratio of any cancer in patients with lower-limb arterial thrombosis was 3.28 (95% CI, 2.79-3.82) at 6 months, 1.42 (95% CI, 1.09-1.83) at 7 to 12 months and 1.14 (95% CI, 1.05-1.24) beyond 12 months, Sundbøll and colleagues wrote.

At 12 months, the strongest associations for patients with lower-limb arterial thrombosis were in smoking-related cancers, including lung cancer (standardized incidence ratio = 5.26; 95% CI, 3.92-6.92), pancreatic cancer (standardized incidence ratio = 7.76; 95% CI, 4.52-12.43) and urinary bladder cancer (standardized incidence ratio = 2.71; 95% CI, 1.48-4.55).

Compared with the comparator group, those with lower-limb arterial thrombosis who had cancer were more likely to die of any cause within 20 years among those who had colon cancer (HR = 1.76; 95% CI, 1.02-3.04), lung cancer (HR = 1.3; 95% CI, 1-1.69), urinary bladder cancer (HR = 2.02; 95% CI, 1.17-3.49) and breast cancer (HR = 2.08; 95% CI, 1.15-3.76) but not prostate cancer (HR = 1.34; 95% CI, 0.86-2.09), according to the researchers.

“Lower-limb arterial thrombosis was a marker of increased risk of cancer — particularly in the short term and most pronounced for smoking-related cancers,” Sundbøll and colleagues wrote. “In addition, lower-limb arterial thrombosis was an adverse prognostic factor for all-cause mortality in patients with colon, lung, urinary bladder and breast cancer, but not prostate cancer. The potential to herald a clinically silent but pre-existing cancer merits increased attention to symptoms or signs pointing to a potential cancer when patients present with lower-limb arterial thrombosis.” – by Erik Swain

Disclosures: The authors report no relevant financial disclosures.