Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of OB/GYN, Weill Cornell Medical College, New York, NY, USA.
Gynecol Oncol. 2023 Mar;170:167-171. doi: 10.1016/j.ygyno.2023.01.012. Epub 2023 Jan 24.
Gynecologic cancers, especially ovarian cancer, are associated with a high incidence of venous thromboembolism (VTE). Recent data have shown the risk of VTE development is not only limited to the postoperative period; there also appears to be an increased risk during neoadjuvant chemotherapy (NACT) administration, prompting the need for better risk stratification in this setting. We sought to assess the risk of VTE development in patients with ovarian cancer undergoing NACT.
We performed a PubMed literature review using the following medical terms: advanced ovarian cancer, advanced peritoneal cancer, advanced fallopian tube cancer, thrombosis, thromboembolic events, and neoadjuvant chemotherapy. Eligible studies included patients with advanced ovarian, fallopian tube, or peritoneal cancer who underwent NACT and had VTE. VTE was defined as either a deep venous thrombosis or a pulmonary embolism.
Seven relevant studies were identified; all 7 were published between 2017 and 2021. Across these studies, we identified 1427 patients who underwent NACT and either had VTE at presentation or developed VTE during their treatment course. Of these patients, 1171 underwent NACT and were at risk for VTE development and were included in our pooled analysis. Of these patients, 144 (12.3%) developed VTE.
VTE prophylaxis may be considered in patients with ovarian cancer undergoing NACT.
妇科癌症，特别是卵巢癌，与静脉血栓栓塞症（VTE）的高发率相关。最近的数据表明，VTE 发展的风险不仅局限于术后期间；在新辅助化疗（NACT）期间似乎也存在更高的风险，这促使我们需要在这种情况下进行更好的风险分层。我们旨在评估接受 NACT 的卵巢癌患者发生 VTE 的风险。
我们使用以下医学术语在 PubMed 文献综述中进行了检索：晚期卵巢癌、晚期腹膜癌、晚期输卵管癌、血栓形成、血栓栓塞事件和新辅助化疗。符合条件的研究包括接受 NACT 且患有 VTE 的晚期卵巢癌、输卵管癌或腹膜癌患者。VTE 定义为深静脉血栓形成或肺栓塞。
确定了 7 项相关研究；所有 7 项研究均发表于 2017 年至 2021 年之间。在这些研究中，我们确定了 1427 名接受 NACT 治疗且在就诊时患有 VTE 或在治疗过程中发生 VTE 的患者。这些患者中，有 1171 名接受 NACT 治疗且有发生 VTE 的风险，并纳入了我们的汇总分析。这些患者中有 144 名（12.3%）发生了 VTE。
接受 NACT 的卵巢癌患者可能需要考虑预防性抗凝治疗。
