Comparison of postoperative venous thromboembolism incidence in gastrointestinal and gynecologic solid tumors. Issue 147 (November 2016)

• Record Type: Journal Article
• Authors: Melancon, Tina; Bivona, Cory; Klenke, Susan; Rockey, Michelle; Huh, Jane; Henry, Dave; Grauer, Dennis; Al-Kasspooles, Mazin; Johnson, Gary; Reynolds, Evelyn; Chapman, Julia
• Is Part Of: Thrombosis research. Issue 147(2016)
• Page Start: 104
• Page End: 107
• Publication Date: 2016-11
• Subjects: Venous thromboembolism -- Extended prophylaxis -- Postoperative -- Cancer -- Risk factors; Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2016.10.007
• Languages: English
• ISSNs: 0049-3848

Abstract

Abstract: Introduction: Studies have shown the benefit of 28 days of extended postoperative venous thromboembolism (VTE) prophylaxis for patients undergoing major cancer surgery in the abdomen or pelvis. We retrospectively evaluated the VTE incidence at the University of Kansas Hospital between gynecologic (GYN) cancer patients, who receive extended prophylaxis, and gastrointestinal (GI) cancer patients, who do not. Methods: Patients were evaluated between January of 2010 and December of 2013, and VTE data for eligible patients were collected for 30 and 90 days postoperatively. Results: The study population composed of 190 GYN and 204 GI patients. Colon and endometrial cancers were the most common diagnoses. For GYN and GI patients respectively, VTE occurred in 4.2% and 5.4% at 30 days ( p = 0.584) and 7.4% and 7.8% at 90 days ( p = 0.514). One VTE-related death occurred in the GI group. GI patients underwent more open surgeries, 77.9% versus 66.3% ( p = 0.010) and had longer postoperative hospital stay, median of 7 versus 4 days ( p < 0.0001). Out of all cancer patients combined, 40% versus 17.9% had stage IV disease and 10.2% versus 0.9% had open surgery in the VTE and non-VTE groups, respectively. Conclusions: There were no significant differences in overall VTE incidence between the two patient groups at 30 and 90 days postoperatively. A majority of VTEs occurred in stage IV patients and patients who underwent open surgeries regardless of diagnosis. Highlights: We compared two surgical oncology patient groups on VTE incidence. No significant decrease in VTE was found with extended prophylaxis at 30 or 90 days. GI cancer patients undergo more open surgeries. GI cancer patients have longer postoperative hospitalizations. Stage IV disease may be a heavily weighted VTE risk factor in our patient groups.