Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States of America.
Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX, United States of America.
Gynecol Oncol. 2024 Sep;188:22-26. doi: 10.1016/j.ygyno.2024.05.028. Epub 2024 Jun 14.
Patients with cervical cancer who are diagnosed with venous thromboembolism (VTE) have worse outcomes compared to those not affected. There has yet to be a reliable method to predict or prevent VTE in cervical cancer patients. Our objective is to describe the incidence of VTE in patients with recurrent and metastatic (r/mCC) and determine risk factors that may predict VTE in this setting.
We performed an observational cohort study of 386 patients with r/mCC who received at least one line of systemic chemotherapy. We collected demographic, clinical, histologic data and Khorana scores for all patients. Inclusion and exclusion criteria were applied before analysis. Statistical analysis was performed using Pearson chi-square, Student's t-test, and Wilcoxon rank-sum.
232 patients were included for evaluation. Mean age was 49 years (range 20-83). The majority (167, 72%) of patients had squamous cell histology. 169 (72.8%) patients received treatment for recurrent disease and 63 (27.2%) for metastatic, stage IVB disease. 180 (78%) patients received prior radiation and 134 (58%) received bevacizumab. VTE was diagnosed in 89 (38%) patients. There were no statistically significant differences amongst clinical and pathologic characteristics between patients who developed VTE and those who did not. There was no significant association between BMI, Khorana score, radiation, bevacizumab, or immunotherapy and the development of VTE.
Approximately 40% of patients with r/mCC experienced a new VTE. There were no independent risk factors that could predict VTE in this population. Due to the overwhelmingly high incidence of VTE, prophylactic anticoagulation could be strongly considered in patients with r/mCC.
与未受影响的患者相比，诊断为静脉血栓栓塞症 (VTE) 的宫颈癌患者预后更差。目前尚无可靠的方法来预测或预防宫颈癌患者的 VTE。我们的目的是描述复发性和转移性 (r/mCC) 患者中 VTE 的发生率，并确定可能预测该人群中 VTE 的危险因素。
我们对接受至少一线系统化疗的 386 例 r/mCC 患者进行了观察性队列研究。我们收集了所有患者的人口统计学、临床、组织学数据和 Khorana 评分。在分析前应用了纳入和排除标准。使用 Pearson 卡方检验、学生 t 检验和 Wilcoxon 秩和检验进行统计学分析。
232 例患者纳入评估。平均年龄为 49 岁（范围 20-83 岁）。大多数（167 例，72%）患者为鳞状细胞组织学。169 例（72.8%）患者接受了复发性疾病的治疗，63 例（27.2%）接受了转移性、IVB 期疾病的治疗。180 例（78%）患者接受了放疗，134 例（58%）患者接受了贝伐单抗治疗。89 例（38%）患者诊断为 VTE。发生 VTE 的患者与未发生 VTE 的患者之间在临床和病理特征方面没有统计学上的显著差异。BMI、Khorana 评分、放疗、贝伐单抗或免疫治疗与 VTE 的发生之间没有显著关联。
大约 40%的 r/mCC 患者发生了新的 VTE。在该人群中，没有可以预测 VTE 的独立危险因素。由于 VTE 的发生率极高，预防性抗凝治疗在 r/mCC 患者中可以强烈考虑。
