Introduction Compared to benign disease, gynecologic cancer surgery has 6-fold higher risk for DVT and 14-fold for PE. Estimated DVT risk was reported 15–40% in major gynecologic procedures without thromboprophylaxis.
Methods MeTHOS is a prospective observational study aiming to evaluate a possible reduction of VTE risk in High Thrombotic Burden (HTB) gynecological cancer patients undergone surgery. Women receiving postoperatively tinzaparin (8.000 Anti-Xa IU, OD) were enrolled after signing informed consent.
Results Intermediate results from 97 women are reported. Major characteristics are depicted in table 1.
Major operations were performed in women with higher BMI (p=0.0067) while severe and extremely severe ones in women with lower BMI, and younger age (p=0.0257) (see figure 1). Extended duration surgeries required in FIGO III-IV stages compared to I-II (70%, 53% respectively, OR:2.1, p=0.1366), in ovarian and endometrial cases (73%, 47% respectively, OR:3.1, p=0.0317).
Median thromboprophylaxis duration was 31 days (27–35) and was not related to surgery duration (p>0.05). Three PE events occurred (3%), two in women >70 years and BMI >30 and one in a severe surgery. No bleeding events related to thromboprophylaxis were recorded.
Conclusions Higher BMI limited the possibilities to achieve extended surgical goals while younger age favored it. Intense postoperative thromboprophylaxis with tinzaparin (8,000IU) for 1 month, for women with active gynecological cancer and HTB (high BMI & age, >2 hours surgery, comorbidities, advanced FIGO stage) was effective and safe. Further research is needed.
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