Article Text

Download PDFPDF
EV459/#956  Venous thromboembolism during chemotherapy in gynecology oncology: a multicenter cohort study
  1. Elisabeth Spenard1,
  2. Genevieve Lennox2,
  3. William Geerts3,
  4. Yulia Lin4,
  5. Christina Lee5,
  6. Lilian Gien6,
  7. Al Covens6,
  8. Katherine Pulman2,
  9. Charles Lim7,
  10. Daniel Yokom7 and
  11. Danielle Vicus8
  1. 1University Laval, Division of Gynecology Oncology, Québec, Canada
  2. 2University of Toronto, Division of Gynecology Oncology, Mississauga, Canada
  3. 3University of Toronto, Department of Medicine and Thromboembolism, Toronto, Canada
  4. 4University of Toronto, Department of Laboratory Medicine and Pathobiology, Toronto, Canada
  5. 5University of Toronto, Department of Hematology, Mississauga, Canada
  6. 6University of Toronto, Sunnybrook Health Sciences Centre, Division of Gynecology Oncology, Toronto, Canada
  7. 7University of Toronto, Department of Medical Oncology, Mississauga, Canada
  8. 8University of Toronto, Department of Gynecologic Oncology, Toronto, Canada

Abstract

Introduction Venous thromboembolism(VTE) is a frequent cause of morbidity and mortality in cancer patients. Although gynecologic cancer, anemia and chemotherapy increase VTE rates, there is limited data on thromboprophylaxis during chemotherapy in gynecology oncology. The aim of this study was to evaluate the prevalence of VTE during chemotherapy in gynecologic oncology, assess patient characteristics and inform practice recommendations.

Methods This prospective cohort study included consecutive gynecologic oncology patients treated with chemotherapy at two academic centers between January 2022-March 2024. Deep venous thrombosis(DVT) or pulmonary embolism(PE) were diagnosed using leg doppler ultrasound or computed tomographic(CT) pulmonary angiography, respectively.

Results Of 226 patients, 17(8%) were diagnosed with a VTE over a median follow-up of 5.2months, including 13 DVT(6%) and 6 PE(3%). Ten(59%) patients were diagnosed during chemotherapy, 5(29%) prior to chemotherapy and 2(12%) after chemotherapy. Ten(59%) underwent first-line chemotherapy and 7(41%) underwent chemotherapy for recurrence. Eleven(65%) received carboplatin/cisplatin-paclitaxel, 3(18%) carboplatin, 1(6%) cisplatin-paclitaxel-bevacizumab, 1(6%) paclitaxel-bevacizumab, and 1(6%) doxorubicin. Nine(53%) had ovarian, 5(29%) endometrial and 3(18%) cervical cancer; 12(71%) were stage III/IV and all had high grade histology. Thirteen(76%) patients had pre-chemotherapy anemia; one received blood transfusions, but no intravenous iron. Proportion of mild(110-119g/L) and moderate(90-109g/L) anemia was 62% and 38%. Nine(53%) had pre-chemotherapy platelets ≥350x109/L. Seven(41%) had hypertension, 4(24%) prior VTE and 1(6%) BMI≥35kg/m2. Eleven(65%) patients with VTE had a Khorana score >2 and would have required thromboprophylaxis during chemotherapy.

Conclusion/Implications Thromboprophylaxis during chemotherapy may be considered in gynecology oncology patients due to high VTE rates, similarly to other cancer types for which primary prophylaxis is recommended.

Statistics from Altmetric.com

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.