Yazarlar : Hurtt C, Cliby W, Weaver A

Yayın : Obstetr Gynecol

Yayın Yılı : 2014

Pubmed Linki : http://www.docguide.com/management-epithelial-ovarian-cancer-setting-concomitant-venous-thromboembolism?tsid=5

Konu : Tromboz

Literatür İçeriği :  INTRODUCTION To describe the short-term perioperative outcomes and overall survival among women with venous thromboembolism (VTE) at initial epithelial ovarian cancer diagnosis.

METHODS Women presenting with VTE within 30 days of epithelial ovarian cancer diagnosis between January 2, 2003, and December 29, 2011, who had primary debulking surgery or primarily managed with neoadjuvant chemotherapy were included. Descriptive statistics and the Kaplan-Meier method were used to estimate overall survival from the time of epithelial ovarian cancer diagnosis with patient characteristics and process-of-care variables retrospectively abstracted.

RESULTS Of the 37 women with VTE within 30 days before epithelial ovarian cancer diagnosis, 28 (75.7%; mean age 64.2 years) underwent primary debulking surgery and 9 (24.3%; mean age 62.7 years) received neoadjuvant chemotherapy. Eastern Cooperative Oncology Group performance status was 0-1 in 75% (n=21) of patients undergoing primary debulking surgery compared with 44% (n=4) of patients undergoing neoadjuvant chemotherapy. Advanced-stage (III-IV) disease was diagnosed in 71.4% (n=20) of the primary debulking surgery cohort; all patients undergoing neoadjuvant chemotherapy were presumed advanced. Among those who underwent primary debulking surgery, 26 (92.9%) had a preoperative inferior vena cava filter placed; only one (11.1%) in the neoadjuvant chemotherapy cohort received an inferior vena cava filter. Perioperative bleeding complications were rare in the primary debulking surgery cohort. Within the primary debulking surgery cohort, median overall survival was 2.14 years and median overall survival in the neoadjuvant chemotherapy cohort was 8.8 months ().(Figure is included in full-text article.)

CONCLUSIONS : Despite preoperative VTE, median overall survival was improved among patients undergoing primary debulking surgery; however, poorer overall survival in the neoadjuvant chemotherapy cohort may reflect a worse performance status or higher proportion of advanced cancer. Preoperative VTE in patients with epithelial ovarian cancer can be safely managed with low rates of bleeding complications.

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