Abstract 6187: Venous thromboembolism in metastatic and non-metastatic head and neck cancer
Authors: Ted Akhiwu, May Gao, Nosayaba Osazuwa-Peters
Journal: Cancer Research (2025)

Abstract Background: Venous thromboembolism (VTE) is a comorbidity in many cancer patients, however, data in patients with head and neck cancer (HNC), as well as the burden in patients with metastatic HNC compared to non-metastatic HNC is limited. This study aimed to examine the prevalence, hospitalization outcomes, and correlations of VTE in patients with HNC. Methods: We utilized retrospective data from the 2016-2020 National Inpatient Sample (NIS) to evaluate VTE in HNC patients. We included adults ≥ 18 years with a diagnosis of HNC using ICD-10 codes. The primary outcome was the odd of VTE among patients with metastatic (M-) vs non-metastatic (NM-) HNC. VTE was defined as deep vein thrombosis (DVT) or pulmonary embolism (PE) using ICD-10 diagnosis codes. Secondary outcomes were the odds of in-patient mortality and prolonged length of stay [LOS (≥ 21 days)] among HNC patients with VTE. We compared demographic, clinical, and hospital characteristics between metastatic and non-metastatic HNC patients using χ2 for categorical and t-tests for continuous variables. Multivariable logistic regression models were fit to assess the relationship between clinical, patient, and hospital characteristics and study outcomes. Results: There were 351850 weighted hospitalizations with a diagnosis of HNC between 2016 and 2020 (23.20% M-HNC and 76.80% NM-HNC). Among HNC patients, 2.74% had VTE (3.26% M-HNC vs 2.59% in NM-HNC). The mean age of HNC patients was 64.11 years (± 11.66) [64.55 years (±11.70) NM-HNC vs 62.63 years (±11.40) M-HNC]. Among HNC patients, higher odds of VTE were associated with Black race (aOR: 1.25, 95% CI 1.08 - 1.43), having higher Charlson comorbidity (CCM) scores [aOR 1.34 (1.20 - 1.50)] and lower odds were associated with Asians/Pacific Islanders (PI) (vs White, aOR0.62 (0.44 - 0.84)] and those undergoing major surgery [(aOR 0.63 (0.54-0.74)]. Among NM-HNC, higher odds of VTE were associated with Black race [(vs white, aOR 1.23 (1.04 - 1.45)] and higher CCM [(aOR 1.19 (1.01 - 1.41)]. Among patients with M-HNC, higher odds of VTE were associated with Black race [(vs White aOR 1.30 (1.02 - 1.68)], and higher CCM [(aOR 1.34 (1.09 - 1.64)] and lower odds were noted in Asian/PI [(vs white aOR 0.44 (0.25 - 0.79)]. VTE was associated with increased odds of in-hospital mortality [aOR 2.26 (1.91-2.67)] and prolonged LOS [AOR 3.60 (3.13-4.15)] overall and in both M-HNC [AOR for mortality 2.06 (1.55-2.73) and LOS 3.36 (2.57 - 4.40] and NM-HNC [AOR for mortality 2.35 (1.91-2.89) and LOS 3.73 (3.16 - 4.41)]. Conclusion: VTE is more prevalent in M-HNC patients and is associated with adverse in-hospital outcomes including increased mortality and a prolonged LOS. Black race and higher comorbidity were positively associated with VTE, while Asian/PI race and head and neck surgery were negatively associated. Findings highlight the need for targeted interventions to prevent VTE in high-risk HNC patients and reduce adverse in-hospital outcomes. Citation Format: Ted Akhiwu, May Gao, Nosayaba Osazuwa-Peters. Venous thromboembolism in metastatic and non-metastatic head and neck cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 6187.