Lee Lisa, Garrett Leslie, Lee Hang, Oliva Esther, Horowitz Neil, Duska Linda R
Division of Gynecologic Oncology, Biostatistics Center, Massachusetts General Hospital, Boston, USA.
J Reprod Med. 2009 Mar;54(3):133-8.
To document the rate of clinically significant venous thromboembolism (VTE) in patients with clear cell carcinoma of the endometrium (CCC-E).
Institutional review board permission was obtained to identify all cases of CCC-E between 1994 and 2004. Controls with high grade endometrial cancers were matched for stage, age and date of diagnosis.
Complete data were available for 29. Age ranged from 38 to 85 (mean, 64.6) years. Thirty-five percent of the patients had stage I tumors, 10% stage II, 27.5% stage III and 27.5% stage IV tumors. Fifty-eight matched controls were selected. Overall there were 18 VTE events: 10 (34.5%) in patients with CCC-E and 8 (13.8%) in the controls (OR = 3.68, p = 0.032). More VTE occurred in patients with stage III/IV disease (n = 16) than those with early stage (n = 2). VTE in patients with CCC-E occurred at presentation or with disease recurrence rather than in the postoperative period (8 vs. 1). Among patients with CCC-E, VTE had an adverse effect on survival, with a hazard ratio of 3.65 (95% CI, 3.14-4.16; p = 0.011).
Patients with CCC-E have greater risk of VTE than patients with other high-risk endometrial cancers. Consideration should be given to extended prophylaxis in patients with CCC-E to prevent VTE.
