Article Text

Download PDFPDF
Signs and Symptoms of Venous Thromboembolism and Survival Outcome of Endometrial Cancer
  1. Hiroko Machida, MD,
  2. Marianne S. Hom, MD,
  3. Midori Maeda, BS,
  4. Jane J. Yeo, MD,
  5. Christian S. Ghattas, MD,
  6. Brendan H. Grubbs, MD and
  7. Koji Matsuo, MD, PhD
  1. * Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Los Angeles County Medical Center, University of Southern California, Los Angeles, CA;
  2. School of Medicine, Niigata University, Niigata, Japan;
  3. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Los Angeles County Medical Center; and
  4. § Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA.
  1. Address correspondence and reprint requests to Koji Matsuo, MD, PhD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Los Angeles County Medical Center, University of Southern California, 2020 Zonal Ave, IRD 520, Los Angeles, CA 90033. E-mail: koji.matsuo{at}med.usc.edu.

Abstract

Objective This study aimed to evaluate if the presence of venous thromboembolism (VTE) diagnosed with subjective and objective measurements correlates with the survival outcome in patients with endometrial cancer.

Methods A retrospective study was conducted on patients with endometrial cancer who developed VTE between cancer diagnosis and follow-up from 1999 to 2013. Disease-specific survival after VTE diagnosis was evaluated according to VTE symptoms and vital signs.

Results Among 827 endometrial cancer cases during the study period, there were 72 (8.7%) patients with VTE identified (pulmonary embolism [PE] with or without deep vein thrombosis [DVT], n = 34; and DVT alone n = 38). In the PE group, decreased disease-specific survival after the diagnosis of VTE was associated with fatigue, systolic blood pressure (BP) less than 120 mm Hg, diastolic BP less than 70 mm Hg, and a heart rate 90 beats per minute or greater (all, P < 0.05) in a univariate analysis. Symptomatic PE was associated with decreased survival as compared to asymptomatic PE (2-year rate; 23.1% vs 77.8%, P < 0.01). In a multivariate analysis controlling for symptoms of VTE, signs, and tumor factors, a diastolic BP less than 70 mm Hg (adjusted-hazard ratio [HR], 10.0; 95% confidence interval, 2.70–37.1; P < 0.01) and HR greater than 90 beats per minute (adjusted-HR, 8.06; 95% confidence interval, 2.36–27.5; P < 0.01) remained as independent prognostic factors for decreased disease-specific survival after PE diagnosis. Patients with PE presenting with low diastolic BP and high heart rate resulted in a dismal survival outcome (diastolic BP < 70 mm Hg/heart rate ≥ 90 beats per minute vs diastolic BP ≥ 70 mm Hg/heart rate < 90 beats per minute; 0% vs 85.7%, P < 0.01). In the group of patients with DVT alone, no signs or symptoms correlated with survival outcome (all, P > 0.05).

Conclusions Our results suggested that both signs and symptoms of PE are important consideration in the management of patients with endometrial cancer with PE.

  • Endometrial cancer
  • Venous thromboembolism
  • Pulmonary embolism
  • Symptom
  • Sign
  • Survival outcome

Statistics from Altmetric.com

Footnotes

  • The authors declare no conflicts of interest.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.