Outcome of Patients with Advanced Neoplastic Disease Receiving Vena Caval Filters

The authors examined the appropriateness and outcome of inferior vena caval (IVC) filter placements in patients with advanced malignancies and limited expected survival. Over a 35-month period, 35 IVC filters were inserted in 34 adult patients with advanced neoplasms. Follow-up was as long as 28 months (mean, 5.2 months). Filter effectiveness, complications, recurrent pulmonary emboli, patient survival, and hospital discharge status were recorded. Twenty-eight patients (82%) were discharged home (n = 21) or to nursing facilities (n = 7) between 1 and 193 days (mean, 23 days) after filter insertion. Six patient (18%) died during hospitalization 1–95 days after filter insertion. The overall mean survival was 6.6 months; for patients with stage III and IV tumors mean survival was 8.0 and 5.5 months, respectively. Even among patients with stage IV disease, 59% survived longer than 3 months. There were no complications related to filter insertion and no clinical evidence of recurrent pulmonary emboli. In 14% of patients, filters enabled invasive therapeutic and palliative procedures to be performed. The presence of advanced neoplastic disease by itself should not be a deterrent to insertion of IVC filters, as most patients survived well beyond initial hospitalization.