TY - JOUR T1 - Signs and Symptoms of Venous Thromboembolism and Survival Outcome of Endometrial Cancer JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 924 LP - 932 DO - 10.1097/IGC.0000000000000684 VL - 26 IS - 5 AU - Hiroko Machida AU - Marianne S. Hom AU - Midori Maeda AU - Jane J. Yeo AU - Christian S. Ghattas AU - Brendan H. Grubbs AU - Koji Matsuo Y1 - 2016/06/01 UR - http://ijgc.bmj.com/content/26/5/924.abstract N2 - 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. ER -