Skip to main content
SpringerLink
Log in

Superficial vein thrombosis and its relationship with malignancies: a prospective observational study

  • Published:
Journal of Thrombosis and Thrombolysis Aims and scope Submit manuscript

Abstract

Background

The interrelation of cancer with venous thromboembolism is established, yet the specific impact on the incidence and progression of superficial vein thrombosis (SVT) remains unclear.

Objectives

To investigate the association between SVT and malignancies, focusing on risk factors, presentation, course and complications.

Methods

A single-center prospective observational study of patients diagnosed with DVT or SVT referred to a venous thromboembolism clinic between January 2013 and April 2018.

Results

Of the 632 patients, 205 presented with SVT at referral, 16.6% having active cancer. Significant associations were found between active cancer and the risk of developing proximal SVT (RR 1.54 [1.18–2.03] p < 0.01), SVT within 3 cm from junction (RR 2.01 [1.13–3.72] p = 0.019), bilateral SVT (RR 8.38 [2.10-33.43] p < 0.01) and SVT affecting multiple veins (RR 2.42 [1.40–4.20] p < 0.01), with a higher risk of persistence (RR 1.51 [1.18–1.95] p < 0.01) and progression (RR 5.75 [2.23–14.79] p < 0.01) at initial assessment. Patients with SVT and no malignancy history demonstrated an elevated risk for new-onset cancer during follow-up (RR 1.43 [1.13–1.18] p = 0.022), especially in cases of proximal or bilateral SVT, initial progression or subsequent DVT or PE. No significant differences were observed in persistence, recurrence or complications during initial evaluation or follow-up across different pharmacological treatments.

Conclusions

Research suggests a probable link between cancer history and the development of SVT. SVT presented more severely in cancer patients. SVT, especially in its more complex forms, could serve as a predictive marker for the future development of cancer. Treatment approaches varied, no significant differences in outcomes were noted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data use and availability

The information used for the preparation of this article has been extracted from the electronic medical record of La Paz University Hospital. A link to these records is not provided in order to maintain the privacy and anonymity of the patients. In this study, no patient data are presented that could potentially compromise their privacy.

References

  1. Blom JW, Doggen CJ, Osanto S, Rosendaal FR (2005) Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA 293(6):715–722. https://doi.org/10.1001/jama.293.6.715Timp

    Article  CAS  PubMed  Google Scholar 

  2. Braekkan JF, Versteeg SK, Cannegieter HH (2013) Epidemiology of cancer-associated venous thrombosis. Blood 122(10):1712–1723

    Article  PubMed  Google Scholar 

  3. Decousus H, Quéré I, Presles E et al (2010) Superficial venous thrombosis and venous thromboembolism: a large, prospective epidemiologic study. Ann Intern Med 152(4):218–224. https://doi.org/10.7326/0003-4819-152-4-201002160-00006

    Article  PubMed  Google Scholar 

  4. Hirmerová J, Seidlerová J, Šubrt I, Hajšmanová Z (2022) Prevalence of cancer in patients with superficial vein thrombosis and its clinical importance. J Vasc Surg Venous Lymphat Disord 10(1):26–32. https://doi.org/10.1016/j.jvsv.2021.05.006

    Article  PubMed  Google Scholar 

  5. Decousus H, Epinat M, Guillot K, Quenet S, Boissier C, Tardy B (2003) Superficial vein thrombosis: risk factors, diagnosis, and treatment. Curr Opin Pulm Med 9(5):393–397. https://doi.org/10.1097/00063198-200309000-00009

    Article  PubMed  Google Scholar 

  6. Sallah S, Wan JY, Nguyen NP (2002) Venous thrombosis in patients with solid tumors: determination of frequency and characteristics. Thromb Haemost 87(4):575–579

    Article  CAS  PubMed  Google Scholar 

  7. Blondon M (2021) Screening for Cancer in patients with acute venous thromboembolic disease. Hamostaseologie 41(1):42–47. https://doi.org/10.1055/a-1339-7328

    Article  PubMed  Google Scholar 

  8. Khorana AA, Noble S, Lee AYY et al (2018) Role of direct oral anticoagulants in the treatment of cancer-associated venous thromboembolism: guidance from the SSC of the ISTH. J Thromb Haemost 16(9):1891–1894. https://doi.org/10.1111/jth.14219

    Article  CAS  PubMed  Google Scholar 

  9. Sørensen HT, Mellemkjaer L, Olsen JH, Baron JA (2000) Prognosis of cancers associated with venous thromboembolism. N Engl J Med 343(25):1846–1850. https://doi.org/10.1056/NEJM200012213432504

    Article  PubMed  Google Scholar 

  10. Khorana AA, Francis CW, Culakova E, Kuderer NM, Lyman GH (2007) Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy. J Thromb Haemost 5(3):632–634. https://doi.org/10.1111/j.1538-7836.2007.02374.x

    Article  CAS  PubMed  Google Scholar 

  11. Haddad TC, Greeno EW (2006) Chemotherapy-induced thrombosis. Thromb Res 118(5):555–568. https://doi.org/10.1016/j.thromres.2005.10.015

    Article  CAS  PubMed  Google Scholar 

  12. Baselet B, Sonveaux P, Baatout S, Aerts A (2019) Pathological effects of ionizing radiation: endothelial activation and dysfunction. Cell Mol Life Sci 76(4):699–728. https://doi.org/10.1007/s00018-018-2956-z

    Article  CAS  PubMed  Google Scholar 

  13. Schultz-Hector S, Trott KR (2007) Radiation-induced cardiovascular diseases: is the epidemiologic evidence compatible with the radiobiologic data? Int J Radiat Oncol Biol Phys 67(1):10–18. https://doi.org/10.1016/j.ijrobp.2006.08.071

    Article  CAS  PubMed  Google Scholar 

  14. Baker JE, Moulder JE, Hopewell JW (2011) Radiation as a risk factor for cardiovascular disease. Antioxid Redox Signal 15(7):1945–1956. https://doi.org/10.1089/ars.2010.3742

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Langer F, Gerlach HE, Schimke A et al (2022) Clinical outcomes of cancer-associated isolated superficial vein thrombosis in daily practice. Thromb Res 220:145–152. https://doi.org/10.1016/j.thromres.2022.10.022

    Article  CAS  PubMed  Google Scholar 

  16. Galanaud JP, Blaise S, Sevestre MA et al (2018) Long-term outcomes of isolated superficial vein thrombosis in patients with active cancer. Thromb Res 171:179–186. https://doi.org/10.1016/j.thromres.2018.04.013

    Article  CAS  PubMed  Google Scholar 

  17. Barco S, Pomero F, Di Minno MND et al (2017) Clinical course of patients with symptomatic isolated superficial vein thrombosis: the ICARO follow-up study. J Thromb Haemost 15(11):2176–2183. https://doi.org/10.1111/jth.13840

    Article  CAS  PubMed  Google Scholar 

  18. Silveira PC, Ip IK, Goldhaber SZ, Piazza G, Benson CB, Khorasani R (2015) Performance of Wells score for deep vein thrombosis in the Inpatient setting. JAMA Intern Med 175(7):1112–1117. https://doi.org/10.1001/jamainternmed.2015.1687

    Article  PubMed  Google Scholar 

  19. Kruger PC, Eikelboom JW, Douketis JD, Hankey GJ (2019) Deep vein thrombosis: update on diagnosis and management. Med J Aust 210(11):516–524. https://doi.org/10.5694/mja2.50201

    Article  PubMed  Google Scholar 

  20. Bruinstroop E, van de Ree MA, Huisman MV (2009) The use of D-dimer in specific clinical conditions: a narrative review. Eur J Intern Med 20(5):441–446. https://doi.org/10.1016/j.ejim.2008.12.004

    Article  CAS  PubMed  Google Scholar 

  21. Gotta J, Gruenewald LD, Eichler K et al (2023) Unveiling the diagnostic enigma of D-dimer testing in cancer patients: current evidence and areas of application. Eur J Clin Invest 53(10):e14060. https://doi.org/10.1111/eci.14060

    Article  CAS  PubMed  Google Scholar 

  22. Temporelli PL, Zito GB, Pedretti RF et al (2014) Farmaci Antiinfiammatori Non Steroidei E Rischio Di eventi cardiovascolari: evidenze dalla letteratura e implicazioni per la pratica clinica [Nonsteroid anti-inflammatory drugs (NSAID) and risk of cardiovascular events. Literature review and clinical implications]. Monaldi Arch Chest Dis 82(3):165–170. https://doi.org/10.4081/monaldi.2014.58

    Article  PubMed  Google Scholar 

  23. Schmidt M, Christiansen CF, Horváth-Puhó E, Glynn RJ, Rothman KJ, Sørensen HT (2011) Non-steroidal anti-inflammatory drug use and risk of venous thromboembolism. J Thromb Haemost 9(7):1326–1333. https://doi.org/10.1111/j.1538-7836.2011.04354.x

    Article  CAS  PubMed  Google Scholar 

  24. Stevens SM, Woller SC, Baumann Kreuziger L et al (2021) Antithrombotic therapy for VTE Disease: second update of the CHEST Guideline and Expert Panel Report. Chest 160(6). https://doi.org/10.1016/j.chest.2021.07.055

  25. Di Nisio M, Wichers IM, Middeldorp S (2018) Treatment for superficial thrombophlebitis of the leg. Cochrane Database Syst Rev 2(2):CD004982 Published 2018 Feb 25. https://doi.org/10.1002/14651858.CD004982.pub6

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors declare no conflicts of interest, including any commercial associations that could present a conflict with this submitted article. This research adheres to the principles of the Declaration of Helsinki and the ethical standards of our institution. We confirm the originality of this work, including its figures, and attest that it has not been previously published or duplicated from any other source. This work is not currently under consideration for publication in any other journal.

Funding

This work has not received any public grants or financial support. No funding sources were used to assist in the preparation of this article.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, La Paz University Hospital, Paseo Castellana 261, Madrid, 28046, Spain

    Alejandro Díez-Vidal & Yale Tung-Chen

  2. Department of Emergency Medicine, La Paz University Hospital, Paseo Castellana 261, Madrid, 28046, Spain

    Javier Gómez López, Pablo Rodríguez Fuertes, Fabián Tejeda Jurado, Paula Berrocal Espinosa, Juan Francisco Martínez Ballester, Sonia Rodríguez Roca, María Angélica Rivera Núñez & Ana María Martínez Virto

  3. Department of Medicine, Alfonso X El Sabio University, Avenida Universidad 1, Villanueva de la Cañada, Madrid, 28691, Spain

    Yale Tung-Chen

Authors
  1. Alejandro Díez-Vidal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Javier Gómez López
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Pablo Rodríguez Fuertes
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fabián Tejeda Jurado
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Paula Berrocal Espinosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Juan Francisco Martínez Ballester
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sonia Rodríguez Roca
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. María Angélica Rivera Núñez
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ana María Martínez Virto
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yale Tung-Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors have contributed to this work. Conception and design: ADV, YTC. Analysis and interpretation: ADV, YTC. Data collection: JGL, PRF, FTJ, PBE, AMV, JFMB, MARN, SRR. Manuscript drafting: ADV, YTC. Critical revision of the article: JGL, PRF, FTJ, PBE, AMV, JFMB, MARN, SRR, YTC, ADV. Final approval of the article: JGL, PRF, FTJ, PBE, AMV, JFMB, MARN, SRR, YTC, ADV. Statistical analysis: ADV. Overall responsibility: ADV, YTC.

Corresponding author

Correspondence to Alejandro Díez-Vidal.

Ethics declarations

Ethics committee approval

This study has received approval from the Ethics Committee of La Paz University Hospital, under the code PI3306. The approval document is included as supplementary material.

Informed consent

All participants provided written informed consent, adhering to ethical standards. The process ensured participants were well-informed about the study’s objectives, procedures and their right to withdraw. For those with diminished capacity, consent was obtained from legal representatives. Ethical review and approval of the used documents were obtained from the Ethics Committee of La Paz University Hospital.

Use of artificial intelligence (AI)

During the preparation of this article, artificial intelligence tools have been employed for targeted grammatical and stylistic corrections.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Díez-Vidal, A., Gómez López, J., Rodríguez Fuertes, P. et al. Superficial vein thrombosis and its relationship with malignancies: a prospective observational study. J Thromb Thrombolysis 57, 650–657 (2024). https://doi.org/10.1007/s11239-024-02963-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11239-024-02963-6

Keywords

Search

Navigation