Back to Search
Start Over
Beyond prophylaxis: Extended risk of venous thromboembolism following primary debulking surgery for ovarian cancer
- Source :
- Gynecologic Oncology. 152:286-292
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Objective To determine the incidence and risk factors for venous thromboembolism (VTE) within six months after primary debulking surgery (PDS) for epithelial ovarian cancer (EOC). Methods In a historical cohort, we estimated the cumulative incidence of clinically diagnosed VTE within 6 months among consecutive women who underwent PDS for EOC at a single institution from 1/1/2003 to 12/31/2011. We evaluated perioperative variables as potential risk factors of VTE within 6 months during the postoperative period using univariate and multivariable Cox proportional hazards models. Results Among 860 women without an immediate history (past 30 days) of a VTE, the cumulative incidence of VTE was 7.5% (95% CI, 5.7–9.3) by 30 days and 13.8% (95% CI, 11.4–16.2) by 6 months following surgery. Macroscopic residual disease (adjusted HR 1.99 [95% CI 1.35–2.94] vs microscopic), increasing estimated blood loss (1.25 [1.05–1.49] per doubling), longer hospital length of stay (3.00 [1.57–5.75]), and experiencing a cardiac event within 30 postoperative days (2.72 [1.55–4.80]) were independently associated with subsequent VTE within 6 months. In-hospital VTE prophylaxis included heterogeneous approaches; dual prophylaxis did not impact 30-day or 6-month VTE rates. Conclusions VTE occurred in 1 in 7 women with EOC within 6 months of PDS—a substantial risk of VTE that extends into the adjuvant chemotherapy period. Novel prophylactic measures should be explored in these women at high risk for VTE.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Kaplan-Meier Estimate
Disease
Carcinoma, Ovarian Epithelial
Cohort Studies
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
medicine
Fallopian Tube Neoplasms
Humans
Cumulative incidence
cardiovascular diseases
Peritoneal Neoplasms
business.industry
Proportional hazards model
Incidence (epidemiology)
Obstetrics and Gynecology
Cytoreduction Surgical Procedures
Venous Thromboembolism
Perioperative
Middle Aged
equipment and supplies
Debulking
medicine.disease
Surgery
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Female
Ovarian cancer
business
Venous thromboembolism
Subjects
Details
- ISSN :
- 00908258
- Volume :
- 152
- Database :
- OpenAIRE
- Journal :
- Gynecologic Oncology
- Accession number :
- edsair.doi.dedup.....814ed7bd0fd737135a5d4130e3692100