Key result
Central venous line dysfunction significantly increased the risk of symptomatic thromboembolism in children with sarcoma compared to those without dysfunction (55.5% vs 8.2%; P=0.002).
Why the study?
What is the prevalence and epidemiology of symptomatic thromboembolism in children with sarcoma?
Observational (n=70)
No
What is the prevalence and epidemiology of symptomatic thromboembolism in children with sarcoma?
Absolute Event Rate: 55.5% vs 8.2%
p-value: p=0.002
Thromboembolism is a significant complication in children with sarcoma, particularly in those with central venous line dysfunction.
Central venous line dysfunction was associated with higher symptomatic thromboembolism risk in pediatric sarcoma; hypothesis-generating for targeted prevention trials.
BACKGROUND: Thromboembolism (TE) is a common complication and cause of death in adults with cancer. Cancer has been identified as a major risk factor in children with TE. However, the information regarding the epidemiology of TE in children with cancer, especially in association with childhood solid tumors, is scant. OBJECTIVE: To define the prevalence and epidemiology of TE in children with sarcoma. PROCEDURE: Hospital records of children </=18 years of age with sarcoma diagnosed and treated at McMaster Children's Hospital during January 1990 to December 2005 were reviewed for demographic details, details of diagnosis and therapy for sarcoma, and details of diagnosis and management of TE. Statistical analysis was performed using Fisher's exact t-test. RESULTS: Ten of 70 (14.3%; 95% CI; 7.1, 24.7) patients with sarcoma developed symptomatic TE. Patients with CVL-dysfunction (n = 9) were at significantly higher risk for symptomatic TE compared to those without CVL dysfunction (n = 61) (55.5 vs. 8.2%; P = 0.002, 95% CI; 14.2, 80.5). Patients with pulmonary disease (n = 23) had higher prevalence of TE compared to those without pulmonary disease (n = 47) (26 vs.8.5%; P = 0.07, 95% CI; -2.06, 37.2). Older patients, patients with metastatic disease and those with Ewing sarcoma had higher prevalence of TE. CONCLUSIONS: TE is a significant complication in children with sarcoma. Over 50% of patients with CVL dysfunction had symptomatic TE; such patients may warrant careful evaluation for associated TE. Large prospective studies are needed to define the epidemiology and identify risk factors predisposing to TE in children with sarcoma.
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Athale et al. (2006) conducted an observational in Sarcoma (n=70). CVL dysfunction vs. No CVL dysfunction was evaluated on Symptomatic thromboembolism (95% CI 14.2-80.5, p=0.002). Central venous line dysfunction significantly increased the risk of symptomatic thromboembolism in children with sarcoma compared to those without dysfunction (55.5% vs 8.2%; P=0.002).
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