Abstract Introduction Venous thromboembolism (VTE) has an increasing incidence worldwide, particularly among cancer patients, who face a significantly higher risk of complications, including pulmonary embolism (PE). The physiopathological particularities of oncological patients, combined with chemotherapy effects, and poor performance status, contribute to a prothrombotic state, making VTE either the first manifestation of cancer or a complication of its treatment. Purpose This study aims to analyze the incidence and risk factors of paraneoplastic DVT and evaluate the role of multidisciplinary management in improving patient outcomes. Methods A retrospective analysis was conducted using data from an emergency hospital. The study included patients diagnosed with DVT, evaluating their risk factors and therapeutic approaches. The methodology incorporated clinical assessments, laboratory markers, and imaging techniques, focusing on the impact of neoplasia on thrombotic complications. Results This study retrospectively analyzed 100 patients diagnosed with DVT, categorizing them into two cohorts based on the presence or absence of an associated neoplasia. Of the total study population, 25% had a concomitant malignancy, with colorectal (26%), uterine (20%), and lung cancers (16%) being the most frequently identified. Among patients with malignancy, 56% also exhibited PE, demonstrating the high thrombotic burden in this subgroup. Gastrointestinal and pulmonary cancers were more frequently associated with isolated DVT. Gynecologic cancers (uterine, ovarian, and cervical) exhibited a higher incidence of concurrent DVT and PE, possibly due to local compression of venous structures and estrogen-related coagulation changes. Cerebral malignancies showed a higher incidence of proximal DVT, with an increased likelihood of recurrent thrombotic events. Patients with metastatic cancer (60%) had a significantly increased risk of bilateral PE, reflecting the hypercoagulability associated with advanced disease. In 25% of cases, VTE was the first manifestation of an undiagnosed malignancy, reinforcing the concept of thrombosis as a paraneoplastic syndrome. The highest proportion of newly diagnosed cancers following a thrombotic event was observed in colorectal, lung, and cervical malignancies, suggesting a need for systematic cancer screening in unprovoked DVT cases. The recurrence rate of DVT was significantly higher in the oncologic cohort (50% in patients under 50 years old). Patients with colorectal cancer and PE had the highest mortality rates, reflecting the advanced nature of disease at diagnosis. Conclusions Paraneoplastic DVT represents a major challenge due to its high incidence, recurrence, and associated mortality. Early detection and risk stratification are essential in improving patient prognosis.
Duca et al. (Fri,) studied this question.