Emily Menendez

GI Oncology Now

Patients diagnosed with cancer face a heightened risk for developing venous thromboembolism (VTE), which can lead to a higher incidence of mortality and other treatment complications. Patients with colorectal cancer (CRC) who develop VTE face heightened risks for recurrence and anticoagulant-related bleeding.
A retrospective study assessed potential risk factors linked to recurrence and bleeding in patients with CRC and VTE, with the impact of these outcomes on survival <a href="https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1648003/abstract" target="_blank" rel="noopener">analyzed during a one-year follow-up.</a>
The study included data from 1,792 patients with CRC and cancer-associated VTE who were treated with anticoagulants from January 2019 to January 2023. The occurrence of recurrent VTE, major bleeding (MB), and clinically relevant non-major bleeding (CRNMB) was also studied.
Associated risk factors were analyzed using univariate and multivariate models, and the impact of anticoagulant treatment outcomes on all-cause mortality was analyzed using the Cox proportional hazards model and the Kaplan-Meier method.
In a competing-risk multivariate analysis, the independent predictors of recurrent VTE included age (HR with 95% CI: 1.005 [1.002-1.008] per year), history of VTE (4.288 [2.902-6.334]), index pulmonary embolism (PE) (1.698 [1.252-2.303]), ECOG greater than or equal to 2 (1.561 [1.036-2.350]), hemoglobin &lt; 100 g/L (1.363 [1.045-1.778]), and aPTT greater than 36.5 s (2.034 [1.223-3.383]).
Factors linked to a lower recurrence risk included recent major surgery or trauma within 1 month (0.451 [0.259-0.786]) and tumor stage II (0.607 [0.377-0.978]) or III (0.562 [0.333-0.949]).
Independent predictors of MB included age 75 or older (1.637 [1.011-2.652]), history of MB (5.320 [1.880-15.050]), ECOG score of 2 or higher (9.979 [4.292-23.203]), antiplatelet therapy (2.592 [1.539-4.367]), and platelet count less than 100×109/L (2.685 [1.336-5.397]). Tumor stage III (0.122 [0.053-0.278]) and metastatic cancer (0.190 [0.086-0.421]) predicted lower bleeding risk.
Independent predictors of CRNMB also included age 75 or older (1.465 [1.005-2.137]), ECOG score of 2 or higher (1.750 [1.184-2.586]), hemoglobin less than 100 g/L (1.870 [1.316-2.657]), and platelet count less than 100×109/L (2.057 [1.076-3.932]). Recurrent VTE, MB, and CRNMB each adversely impacted one-year survival.
VTE recurrence, MD, and CRNMB significantly impact one-year all-cause mortality risk in patients with CRC. These independent risk factors of VTE may help to serve as a reference for improving risk stratification in patients with CRC receiving anticoagulant therapies.

Patients diagnosed with cancer face a heightened risk for developing venous thromboembolism (VTE), which can lead to a higher incidence of mortality and other treatment complications. Patients with colorectal cancer (CRC) who develop VTE face heightened risks for recurrence and anticoagulant-related bleeding.A retrospective study assessed potential risk factors linked to recurrence and bleeding in patients with CRC and VTE, with the impact of these outcomes on survival <a href="https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1648003/abstract" target="_blank" rel="noopener">analyzed during a one-year follow-up.</a>The study included data from 1,792 patients with CRC and cancer-associated VTE who were treated with anticoagulants from January 2019 to January 2023. The occurrence of recurrent VTE, major bleeding (MB), and clinically relevant non-major bleeding (CRNMB) was also studied.Associated risk factors were analyzed using univariate and multivariate models, and the impact of anticoagulant treatment outcomes on all-cause mortality was analyzed using the Cox proportional hazards model and the Kaplan-Meier method.In a competing-risk multivariate analysis, the independent predictors of recurrent VTE included age (HR with 95% CI: 1.005 [1.002-1.008] per year), history of VTE (4.288 [2.902-6.334]), index pulmonary embolism (PE) (1.698 [1.252-2.303]), ECOG greater than or equal to 2 (1.561 [1.036-2.350]), hemoglobin &lt; 100 g/L (1.363 [1.045-1.778]), and aPTT greater than 36.5 s (2.034 [1.223-3.383]).Factors linked to a lower recurrence risk included recent major surgery or trauma within 1 month (0.451 [0.259-0.786]) and tumor stage II (0.607 [0.377-0.978]) or III (0.562 [0.333-0.949]).Independent predictors of MB included age 75 or older (1.637 [1.011-2.652]), history of MB (5.320 [1.880-15.050]), ECOG score of 2 or higher (9.979 [4.292-23.203]), antiplatelet therapy (2.592 [1.539-4.367]), and platelet count less than 100×109/L (2.685 [1.336-5.397]). Tumor stage III (0.122 [0.053-0.278]) and metastatic cancer (0.190 [0.086-0.421]) predicted lower bleeding risk.Independent predictors of CRNMB also included age 75 or older (1.465 [1.005-2.137]), ECOG score of 2 or higher (1.750 [1.184-2.586]), hemoglobin less than 100 g/L (1.870 [1.316-2.657]), and platelet count less than 100×109/L (2.057 [1.076-3.932]). Recurrent VTE, MB, and CRNMB each adversely impacted one-year survival.VTE recurrence, MD, and CRNMB significantly impact one-year all-cause mortality risk in patients with CRC. These independent risk factors of VTE may help to serve as a reference for improving risk stratification in patients with CRC receiving anticoagulant therapies.

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A retrospective study assessed potential risk factors linked to recurrence and bleeding in patients with CRC and VTE, with the impact of these outcomes on survival analyzed.