Tumor Type Determines Thrombotic and Bleeding Risk in Cancer-Associated VTE – RPTH Journal
RPTH Journal shared a post on LinkedIn about a recent article by Olga Gavín Sebastián et al, adding:
“Not all cancer-associated VTE behaves the same. And this study proves it!
We often treat cancer-associated thrombosis as one disease.
But what if the type of cancer dramatically changes the balance between clotting and bleeding?
A large RIETE registry analysis of 4,721 women with breast, ovarian, or uterine cancer and VTE delivers a powerful message:
The clinical course of VTE is cancer-specific.
Here’s what stood out
- Ovarian cancer – most thrombotic
Highest VTE recurrence rate: 7.29 per 100 patient-years - Uterine cancer – most bleeding
Highest major bleeding rate: 11.1 per 100 patient-years
Higher fatal bleeding and mortality - Breast cancer – lowest overall risk
Recurrence: 2.70 per 100 patient-years
Major bleeding: 2.73 per 100 patient-years
In multivariable analysis:
- Ovarian cancer: higher VTE recurrence and mortality
- Uterine cancer: higher recurrence, bleeding risk, and mortality
Translation:
The ‘one-size-fits-all’ anticoagulation approach in cancer may no longer be enough.
This study makes a strong case for tumor-specific anticoagulation strategies and future trials stratified by cancer type.
Big questions for the community:
- Should anticoagulation guidelines become cancer-type specific?
- Could tailored dosing or drug choice improve outcomes?
- Are we underestimating bleeding risk in uterine cancer?”
Title: Venous thromboembolism in patients with breast, ovarian, and uterine cancer. A comparative analysis from the Registro Informatizado Enfermedad TromboEmbólica registry
Authors: Olga Gavín Sebastián, Javier Trujillo-Santos, María del Carmen Díaz-Pedroche, Pablo Demelo-Rodríguez, Sonia Otálora, Benjamin Brenner, José María Pedrajas, Alessandra Bura-Riviere, Luis Hernández-Blascom, Manuel Monreal
Read the Full Article on RPTH.

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