Clinical Study of 23 Cases of Occult Malignancy Diagnosed within 1 Month after Symptomatic Venous Thromboembolism

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Symptomatic Venous Thromboembolism (n=482). Intervention: Symptomatic Venous Thromboembolism. Primary outcome: Occult malignancy diagnosed within 1 month after VTE diagnosis.

Q: What does this research mean for the field?

Symptomatic venous thromboembolism is associated with a 4.8% incidence of occult malignancy diagnosed within 1 month after presentation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Mai Matsukawa; Ryo Hirayama; Takeshi Sakaguchi; Kenta Uekihara; Tomoya Miyamoto; Takenori Kojima; Ryusuke Suzuki

doi:10.7133/jca.26-00015

October 9, 2026The Journal of Japanese College of AngiologyOpen Access

Clinical Study of 23 Cases of Occult Malignancy Diagnosed within 1 Month after Symptomatic Venous Thromboembolism

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Key result

Symptomatic VTE is linked to ~5% incidence of occult cancer within 1 month.

n=482

Why the study?

Malignant tumors are a major risk factor for VTE, but the clinical characteristics and early detection of occult malignancy within 1 month after symptomatic VTE remain unclear.

Key Points

To investigate the clinical characteristics, detection triggers, and tumor profiles of occult malignancies diagnosed within 1 month of symptomatic venous thromboembolism (VTE).
Retrospective single-center study analyzing 482 patients diagnosed with symptomatic VTE without previously known active malignancy between April 2019 and March 2025.
Compared baseline characteristics, D-dimer levels, and thrombus locations between patients with occult malignancy detected within 1 month (n=23) and those without (n=451).
Occult malignancy was identified in 23 of 482 patients (4.8%), most commonly ovarian cancer (6 cases); 10 cases were stage IV and 6 cases were stage I.
Median D-dimer was 11.6 µg/mL (IQR: 5.6–28.0) in the malignancy group versus 7.0 µg/mL (IQR: 3.3–15.6) in the non-malignancy group (p=0.055), with 73.9% (17/23) lacking transient VTE risk factors.
Among patients with lower-limb DVT and occult malignancy (n=21), proximal pelvic or femoral vein thrombosis was present in 47.6% (10/21) and bilateral DVT in 38.1% (8/21).

Study Design

Type

Observational (n=482)

Multicenter

No

Structured PICO

P

Population

482 patients with symptomatic venous thromboembolism, free of prior known cancer, evaluated retrospectively for the diagnosis of occult malignancy within 1 month.

C

Comparator

Patients without malignancy identified within 1 month of VTE diagnosis (n=451).

O

Outcome

Incidence and clinical characteristics of occult malignancy identified within 1 month of symptomatic VTE diagnosis.

Careful clinical and imaging assessment at the time of symptomatic VTE diagnosis is crucial, as nearly 5% of patients may harbor an occult malignancy detectable within 1 month.

Limitations

Retrospective, single-center observational design.
Potential for incomplete follow-up if patients relocated or received care at other institutions.
Limited to a 1-month observation period for defining occult malignancy, which may miss cancers diagnosed later.
Single-center retrospective analysis with a limited number of cases
Potential selection bias as the institution is a regional cancer center, possibly accumulating patients with a higher prevalence of malignancy
Incomplete capture of long-term new cancer diagnoses beyond 1 month due to the retrospective chart review design

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Implication

Supports heightened suspicion for occult malignancy in symptomatic VTE; leaves open optimal screening protocols for prospective validation.

Abstract

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Discussion

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Cite This Study

Matsukawa et al. (2026) conducted an observational in Symptomatic Venous Thromboembolism (n=482). Symptomatic Venous Thromboembolism was evaluated on Occult malignancy diagnosed within 1 month after VTE diagnosis. Symptomatic venous thromboembolism was associated with a 4.8% incidence of occult malignancy diagnosed within 1 month after VTE presentation.

synapsesocial.com/papers/6acc29b9005c34d980820f28 https://doi.org/10.7133/jca.26-00015

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Clinical Study of 23 Cases of Occult Malignancy Diagnosed within 1 Month after Symptomatic Venous Thromboembolism

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Clinical Study of 23 Cases of Occult Malignancy Diagnosed within 1 Month after Symptomatic Venous Thromboembolism

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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