Incidence and potential predictors of thromboembolic events in epithelial ovarian carcinoma patients during perioperative period

Eur J Surg Oncol. 2020 May;46(5):855-861. doi: 10.1016/j.ejso.2020.01.026. Epub 2020 Jan 20.

Abstract

Objective: To assess the incidence and the risk factors of venous thromboembolism (VTE) in patients with epithelial ovarian carcinoma (EOC) during the perioperative period.

Methods: A retrospective analysis was conducted on the patients with epithelial ovarian cancer treated in our hospital, between January 2017 and July 2019, and a comprehensive review of the medical documentation was performed to collect relevant data. We then analyzed the related factors of the thrombosis in the EOC patients, using univariate and multivariate analysis to identify significant risk factors for VTE, and bootstrap resampling method was used to verify the multivariate analysis results. The ROC curve methods were conducted to evaluate the diagnostic value for the prediction of VTE.

Results: We analyzed 233 cases of patients with EOC, of whom the incidence of VTE was 11.16%. According to multivariate and 5000 bootstrap samples analysis, preoperative D-dimer levels (>4.215 μg/ml, p = 0.041 and p = 0.032) and comorbid of cerebral infarction (p < 0.001 and p < 0.001) had statistical significance in predicting VTE events; bootstrap analysis also found the Alb, CA125, OCCC had statistical significance. While According to multivariate and 5000 bootstrap samples analysis, age (>50.5 years old, p = 0.019 and p = 0.002) and nonoptimal debulking surgery (p = 0.007 and p = 0.002) showed significance in predicting VTE after surgery; bootstrap analysis also found the D-dimer levels (>4.215 μg/ml) and tuberculosis had statistical significance.

Conclusion: More effective thromboprophylaxis and pre-test assessment is necessary for EOC patients. For prediction VTE events, D-dimer levels (>4.215 μg/ml) were the independent predictors before operation. Age and debulking surgery were the independent predictors post operation.

Keywords: D-dimer; Epithelial ovarian cancer (EOC); Optimal debulking surgery; Perioperative; Venous thromboembolism (VTE).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma, Clear Cell / epidemiology
  • Adenocarcinoma, Clear Cell / metabolism
  • Adenocarcinoma, Clear Cell / pathology
  • Adenocarcinoma, Clear Cell / surgery
  • Adenocarcinoma, Mucinous / epidemiology
  • Adenocarcinoma, Mucinous / metabolism
  • Adenocarcinoma, Mucinous / pathology
  • Adenocarcinoma, Mucinous / surgery
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • CA-125 Antigen / metabolism
  • Carcinoma, Endometrioid / epidemiology
  • Carcinoma, Endometrioid / metabolism
  • Carcinoma, Endometrioid / pathology
  • Carcinoma, Endometrioid / surgery
  • Carcinoma, Ovarian Epithelial / epidemiology
  • Carcinoma, Ovarian Epithelial / metabolism
  • Carcinoma, Ovarian Epithelial / pathology
  • Carcinoma, Ovarian Epithelial / surgery*
  • Cerebral Infarction / epidemiology
  • Comorbidity
  • Cytoreduction Surgical Procedures / methods
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Humans
  • Hypertension / epidemiology
  • Incidence
  • Length of Stay
  • Membrane Proteins / metabolism
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms, Cystic, Mucinous, and Serous / epidemiology
  • Neoplasms, Cystic, Mucinous, and Serous / metabolism
  • Neoplasms, Cystic, Mucinous, and Serous / pathology
  • Neoplasms, Cystic, Mucinous, and Serous / surgery
  • Ovarian Neoplasms / epidemiology
  • Ovarian Neoplasms / metabolism
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery*
  • Perioperative Period*
  • Postoperative Complications / epidemiology*
  • Pulmonary Embolism / epidemiology*
  • Pulmonary Embolism / metabolism
  • ROC Curve
  • Retrospective Studies
  • Risk Factors
  • Serum Albumin / metabolism
  • Tuberculosis / epidemiology
  • Venous Thromboembolism / epidemiology*
  • Venous Thromboembolism / metabolism
  • Venous Thrombosis / epidemiology*
  • Venous Thrombosis / metabolism
  • Young Adult

Substances

  • CA-125 Antigen
  • Fibrin Fibrinogen Degradation Products
  • MUC16 protein, human
  • Membrane Proteins
  • Serum Albumin
  • fibrin fragment D