Jahnson Staffan, Gårdmark Truls, Hosseini Abolfazl, Jerlström Tomas, Liedberg Fredrik, Malmström Per-Uno, Hagberg Oskar, Sherif Amir, Ströck Viveka, Söderkvist Karin, Ullen Anders, Häggström Christel, Holmberg Lars, Aljabery Firas
Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden.
Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden.
Bladder Cancer. 2021 May 25;7(2):161-171. doi: 10.3233/BLC-200409. eCollection 2021.
Routine VTE prophylaxis within 30 days of radical cystectomy (RC) for urinary bladder cancer (UBC) is used to protect from venous thromboembolism (VTE). However, randomized studies and nationwide population-based studies are lacking.
To study VTE and risk factors for VTE in muscle-invasive UBC in a nationwide population-based series, with a focus on the association with RC with and without chemotherapy.
We studied all patients with clinical stage T2-T4 UBC diagnosed 1997 to 2014 in the Bladder Cancer Data Base Sweden (BladderBaSe). Previous VTE events and risk factors for VTE were registered from 1987. Cox regression analyses and Kaplan-Meier curves were performed to study risk factors for VTE and cumulative incidence of VTE.
In 9720 patients (71%males) with a median age of 74 years 546 (5.6%) had VTE after diagnosis. In Cox analyses controlling for patient's and tumour characteristics, and risk factors for VTE, VTE after diagnosis and first treatment date were associated with chemotherapy with or without RC. Cumulative incidence of VTE increased during 24 months after diagnosis and first treatment date. VTE were less common in patients with previous cardiovascular disease.
VTE was commonly observed after 30 days from diagnosis and from first treatment date in patients with T2-T4 UBC, particularly after chemotherapy. The findings suggest that long-term intervention studies of benefit and possible harms of VTE prophylaxis after UBC should be undertaken.
膀胱癌根治性膀胱切除术（RC）后30天内进行常规静脉血栓栓塞（VTE）预防，以预防静脉血栓栓塞症（VTE）。然而，缺乏随机研究和基于全国人群的研究。
在一项基于全国人群的系列研究中，研究肌肉浸润性膀胱癌（UBC）患者的VTE及其危险因素，重点关注与接受或未接受化疗的RC的相关性。
我们研究了1997年至2014年在瑞典膀胱癌数据库（BladderBaSe）中诊断为临床分期T2 - T4的UBC的所有患者。自1987年起记录既往VTE事件和VTE危险因素。进行Cox回归分析和Kaplan - Meier曲线分析，以研究VTE的危险因素和VTE的累积发生率。
在9720例患者（71%为男性）中，中位年龄为74岁，546例（5.6%）在诊断后发生VTE。在控制患者和肿瘤特征以及VTE危险因素的Cox分析中，诊断后和首次治疗日期的VTE与接受或未接受RC的化疗相关。诊断和首次治疗日期后24个月内VTE的累积发生率增加。既往有心血管疾病的患者VTE较少见。
在T2 - T4 UBC患者中，诊断后和首次治疗日期30天后常见VTE，尤其是化疗后。研究结果表明，应开展关于UBC后VTE预防的益处和可能危害的长期干预研究。
