Patients with cancer present a higher risk of rethrombosis and bleeding secondary to anticoagulant treatment than individuals without cancer. Given the lack of specific clinical trials, the decision regarding the optimal duration of treatment must consider multiple factors, including sex. The current study used data from the international, prospective TESEO Registry that includes consecutive patients diagnosed with cancer-associated thrombosis (CAT). Between July 2018 and December 2022, 2,823 patients were included in the TESEO Registry, 1,351 (48%) of whom were female. The most common venous thromboembolic event (VTE) in both sexes was pulmonary embolism (PE), with an incidence of 58.0% among men and 54.3% in women (p=0.045). After a median follow-up of 6.9 months (IQR, 1.9-14.4), the rethrombosis rate at the end of follow up was 10.0% in males and 15.0% in females (p=0.14). The location of the primary tumor in the gastrointestinal tract was associated with a greater risk of rethrombosis, whereas sex had no significant impact. Men presented twice as many major bleeds. Additional risk factors for major bleeding included situations of risk due to tumor site or thrombocytopenia, as well as the presence of active tumor bleeding at the time of VTE diagnosis. Overall survival was higher among women. Given the higher incidence of major bleeding among men, sex should be deemed a relevant factor when deciding on the duration of anticoagulant treatment in cancer patients.

中文翻译：

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癌症相关血栓形成：生物性别对血栓形成和出血风险的影响。


与非癌症患者相比，癌症患者继发于抗凝治疗后继发的血栓形成和出血的风险更高。鉴于缺乏具体的临床试验，关于最佳治疗持续时间的决定必须考虑多种因素，包括性别。目前的研究使用了来自国际前瞻性 TESEO Registry 的数据，其中包括被诊断患有癌症相关血栓形成 （CAT） 的连续患者。2018 年 7 月至 2022 年 12 月期间，TESEO 登记处纳入了 2,823 名患者，其中 1,351 名 （48%） 为女性。男女最常见的静脉血栓栓塞事件 （VTE） 是肺栓塞 （PE），男性发生率为 58.0%，女性为 54.3% （p=0.045）。中位随访 6.9 个月 （IQR，1.9-14.4） 后，随访结束时男性血栓形成率为 10.0%，女性为 15.0% （p=0.14）。原发肿瘤在胃肠道中的位置与更大的血栓形成风险相关，而性别没有显着影响。男性出现大量出血的人数是男性的两倍。大出血的其他危险因素包括肿瘤部位或血小板减少症引起的风险情况，以及 VTE 诊断时存在活动性肿瘤出血。女性的总生存率更高。鉴于男性大出血的发生率较高，在决定癌症患者抗凝治疗的持续时间时，应将性别视为一个相关因素。