Clinical presentation and outcomes of patients with cancer-associated isolated distal deep vein thrombosis

Distal deep vein thrombosis (DVT) is generally a less ominous form of venous thromboembolism than proximal DVT. It is uncertain if such findings are also observed in cancer patients. Analysis of the multinational Registro Informatizado TromboEmbolica venosa register found that the risks of death, VTE recurrences, and major bleeding were much higher in patients with cancer-associated versus non-cancer-associated DVT. The one-year risks of death (aHR 1.01) and VTE recurrence (aHR 1.02) were similar in cancer-associated proximal versus distal DVT. Fatal pulmonary embolism, although uncommon, occurred more frequently in patients with cancer with proximal DVT. The authors conclude that cancer-associated distal DVT has serious and relatively comparable outomes compared with cancer-associated proximal DVT supporting the use of anti-coagulation in this setting.