Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB.
Cross Cancer Institute, Edmonton, AB; Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB.
J Obstet Gynaecol Can. 2021 Dec;43(12):1380-1387. doi: 10.1016/j.jogc.2021.05.010. Epub 2021 Jun 1.
To determine the incidence of venous thromboembolism (VTE) in patients with ovarian cancer receiving neoadjuvant chemotherapy (NACT), identify risk factors for VTE, and assess the effect of VTE on treatment trajectory and overall survival.
This is a retrospective cohort study of patients diagnosed with ovarian, fallopian tube, or primary peritoneal cancer treated with NACT between 2013 to 2016 in Alberta, Canada. The primary outcome was incidence of VTE during NACT. Secondary outcomes were risk factors for VTE and overall survival. Data related to patient demographics, cancer treatment, and incidence of VTE were collected. Statistical analyses included Kaplan-Meier estimates and univariate and multivariate Cox regression analysis.
A total of 284 patients were included in this study. Average age at diagnosis was 63.8 years. The incidence of VTE during NACT was 13.3%. Patients with VTE were less likely to undergo interval debulking surgery (58.3%) than patients without VTE (78.6%). Kaplan-Meier estimates demonstrated a decrease in overall survival in patients who had VTE during NACT (15.0 mo; 95% CI 14.5-16.5) compared with patients who did not (26.8 mo; 95% CI 22.8-30.9) (P < 0.0001). Multivariate analysis identified albumin <35 g/L, BMI >30 kg/m, and non-serous histology as risk factors for VTE.
The risk of VTE in this cohort was 13.3%, which was associated with decreased overall survival. These findings suggest that thromboprophylaxis may have a role in this patient population.
确定接受新辅助化疗（NACT）的卵巢癌患者静脉血栓栓塞症（VTE）的发生率，确定 VTE 的危险因素，并评估 VTE 对治疗轨迹和总生存的影响。
这是一项在加拿大艾伯塔省于 2013 年至 2016 年间接受 NACT 治疗的卵巢癌、输卵管癌或原发性腹膜癌患者的回顾性队列研究。主要结局是 NACT 期间 VTE 的发生率。次要结局是 VTE 的危险因素和总生存。收集了与患者人口统计学、癌症治疗和 VTE 发生率相关的数据。统计分析包括 Kaplan-Meier 估计和单变量及多变量 Cox 回归分析。
本研究共纳入 284 例患者。诊断时的平均年龄为 63.8 岁。NACT 期间 VTE 的发生率为 13.3%。发生 VTE 的患者较未发生 VTE 的患者更不可能进行间隔减瘤手术（58.3% vs. 78.6%）。Kaplan-Meier 估计显示，在 NACT 期间发生 VTE 的患者的总生存率下降（15.0 个月；95%CI 14.5-16.5），而未发生 VTE 的患者的总生存率为 26.8 个月（95%CI 22.8-30.9）（P<0.0001）。多变量分析确定白蛋白<35 g/L、BMI>30 kg/m2 和非浆液性组织学为 VTE 的危险因素。
本队列的 VTE 风险为 13.3%，与总生存率下降相关。这些发现表明，在这一患者人群中，血栓预防可能有一定作用。
