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Abstract
Introduction/Background Venous thromboembolism has a higher incidence among cancer patients given the hypercoagulable state. It is the leading cause of mortality among gynecological cancer patients.
The objectives were to study the clinicopathological characteristics of patients with gynecological malignancies diagnosed with DVT and study the impact of DVT on survival.
Methodology A retrospective study was conducted in our department from 1st January 2019 to 31st December 2021. It included patients with gynecological malignancies diagnosed with DVT. Variables related to cancer and treatment were obtained from the medical records. The imaging modality used and details of DVT and its treatment were recorded. The patients were followed up with Doppler at three monthly intervals till 1 year.
Results 82 patients were included in the study (uterine-13.4%, cervical- 41.46%, ovary-39.02%). The most common histology was squamous cell carcinoma (39.02%) in cervical cancer, and high-grade serous carcinoma (31.7%) in ovarian cancer patients. 50% of the patients were Stage 3. Lower limb DVT was seen in 95.12% and acute thrombus in 84.15%. Enoxaparin was used for the treatment of DVT in 56% of the patients. Pulmonary embolism (PE) had occurred in 10.97%. The occurrence of PE, involvement of multiple veins, acute thrombus and presence of cardiac disease had a significant impact on survival(p=0.04) After 1-year, resolution of the thrombus was complete (43.9%), partial (23.1%), stable (9.7%) and there was progression in 23.1%.
The overall survival after 2 years was 75.6%.
Conclusion This study showed that among patients with gynecological cancer diagnosed with DVT: the presence of stage 3 cancer, acute thrombus, and use of chemotherapy were poor prognostic factors. Despite the routine use of pharmacological thromboprophylaxis post-surgery, 21 patients developed VTE hence highlighting the use of extended thromboprophylaxis in these patients.
Disclosures Funding: none
Competing interests: None declared.
Ethics committee approval obtained from Institutional Ethics Committee.
