Risk of venous thromboembolism in ovarian cancer patients receiving neoadjuvant chemotherapy

被引:25
作者
Basaran, Derman [1 ]
Boerner, Thomas [1 ]
Suhner, Jessa [1 ]
Sassine, Dib [1 ]
Liu, Ying [2 ,3 ]
Grisham, Rachel N. [2 ,3 ]
Tew, William P. [2 ,3 ]
Gardner, Ginger J. [1 ,3 ]
Zivanovic, Oliver [1 ,3 ]
Sonoda, Yukio [1 ,3 ]
Roche, Kara Long [1 ,3 ]
Chi, Dennis S. [1 ,3 ]
Abu-Rustum, Nadeem R. [1 ,3 ]
Soff, Gerald A. [2 ,3 ]
Jewell, Elizabeth L. [1 ,3 ]
机构
[1] Mem Sloan Kettering Canc Ctr, Dept Surg, 1275 York Ave, New York, NY 10021 USA
[2] Mem Sloan Kettering Canc Ctr, Dept Med, 1275 York Ave, New York, NY 10021 USA
[3] Cornell Univ, Joan & Sanford I Weill Med Coll, New York, NY 10021 USA
关键词
Ovarian Cancer; Neoadjuvant therapy; Venous thromboembolism; Survival; COHORT; EPIDEMIOLOGY;
D O I
10.1016/j.ygyno.2021.07.030
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose. To determine the incidence of venous thromboembolism (VTE) and define clinical risk factors asso-ciated with the development of new-onset VTE in patients receiving neoadjuvant chemotherapy (NACT) for ovarian cancer (OC). Methods. An institutional ovarian cancer database was used to identify all OC patients receiving NACT from 04/2015-09/2018. VTE events were recorded and included clinically diagnosed deep venous thrombosis (DVT) and/or pulmonary embolism (PE). The incidence of VTE events was categorized according to treatment phases (P): P0) First visit/prior to induction of NACT; P1) during NACT before interval debulking surgery (IDS); P2) in-traoperative through day 28 post-IDS; P3) during adjuvant chemotherapy. Results. A total of 290 patients were identified during the study period. Seventy-five (25.9%) developed a VTE at some point from time of presentation through the peri-operative period. Forty (13.8%) presented with VTE prior to initiation of NACT. An additional 27 (11.6%) developed a VTE during NACT (P1); 6 (3.9%) during the in-traoperative and 28-day post-operative period (P2); and 2 (1.3%) during the adjuvant period (P3). The overall VTE rate was 25.9% (n = 75). FIGO stage IV disease was the only factor associated with increased risk for a new-onset VTE [Odds Ratio (OR): 3.9 (95% Confidence Interval [CI] = 1.2-13.6; p = 0.03]. Conclusions. Patients receiving NACT for advanced OC are at extremely high risk for developing thromboem-bolic events, either at initial presentation or during induction of NACT, a treatment phase that is traditionally without use of prophylactic anticoagulation. Since Khorana scoring is not predictive in this population, clinicians might need to consider increased screening or use of prophylactic anticoagulation in patients receiving NACT for OC, particularly in advanced metastatic disease. (c) 2021 Elsevier Inc. All rights reserved.
引用
收藏
页码:36 / 40
页数:5
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