Objectives There is paucity of data on venous thromboembolism (VTE) in patients receiving neoadjuvant chemotherapy (NACT) for ovarian cancer. We explored the incidence and predictors of VTE in this patient population.

Methods We performed a retrospective review of women with primary ovarian, fallopian tube or peritoneal cancer who received NACT from January 2012 to October 2018. Patients with a history of VTE prior to cancer diagnosis were excluded. The primary outcome was incidence of deep vein thrombosis (DVT) or pulmonary embolism (PE) after cancer diagnosis and before interval debulking surgery. We explored demographic and clinical variables associated with VTE.

Results VTE was diagnosed in 25 (28%) of 90 patients and 16 (64%) had PE. 67% of patients had VTE during NACT and 8 patients after their cancer diagnosis, before initiation of NACT. The majority of patients had stage III disease and serous adenocarcinoma. African Americans were 3 times more likely than other races to experience VTE (OR 3.22; CI 0.997–10.42; P = 0.051). Significantly more patients without VTE had debulking surgery (88% vs 60%, P = 0.005). The risk of DVT increased by 8.7% per year of age (OR 1.087; 95% CI 1.01–1.17). Obesity, smoking status, medical comorbidities, disease stage, histology, invasive diagnostic surgery, and length of NACT were not predictors of VTE.

Conclusions The incidence of VTE during neoadjuvant chemotherapy is high. Older age and African American race may be potential risk factors for VTE. This information will help mitigate disparities in the treatment of advanced stage ovarian cancer.