Rautiola Juhana, Björklund Johan, Zelic Renata, Pellegrino Francesco, Vincent Per Henrik, Wiklund Peter, Aly Markus, Falconer Henrik, Akre Olof
Department of Molecular Medicine and Surgery, Karolinska Institutet and Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institutet and Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden.
Eur J Surg Oncol. 2025 Oct;51(10):110326. doi: 10.1016/j.ejso.2025.110326. Epub 2025 Jul 14.
To evaluate the risk of venous thromboembolic events in patients operated with radical cystectomy or radical prostatectomy and pelvic lymph-node dissection.
Patients operated with radical cystectomy for bladder cancer or with radical prostatectomy for prostate cancer from 1997 through 2016 were identified from Swedish nationwide registers. We estimated odds ratios of association between lymph-node dissection and pulmonary embolism and deep venous thrombosis (DVT) using logistic regression adjusted for the probability of having lymph-node dissection.
In total, 6069 patients operated with radical cystectomy and 36 911 patients with radical prostatectomy were included. The risk of pulmonary embolism and DVT after radical cystectomy with lymph-node dissection was 1,89 % and 2,29 %, and without lymph-node dissection 1,99 % and 2,35 %, respectively. After radical prostatectomy and lymph-node dissection the risk for pulmonary embolism and DVT were 0,97 % and 1,36 %, and without lymph-node dissection 0,42 % and 0,49 %, respectively. Pelvic lymph-node dissection during a radical cystectomy was not associated with pulmonary embolism (OR 0,99; 95 % CI 0,65-1,51) or DVT (OR 0,99; 95 % CI 0,68-1,48), whereas lymph-node dissection during radical prostatectomy was associated with higher odds of both pulmonary embolism (OR 2,29; 95 % CI 1,67-3,09) and DVT (OR 2,95; 95 % CI 2,27-3,85).
Pelvic lymph-node dissection did not increase the risk of venous thromboembolism after a cystectomy, whereas we found an increased relative risk of venous thromboembolic events associated with radical prostatectomy with lymph-node dissection.
评估接受根治性膀胱切除术或根治性前列腺切除术及盆腔淋巴结清扫术患者发生静脉血栓栓塞事件的风险。
从瑞典全国登记处确定1997年至2016年期间因膀胱癌接受根治性膀胱切除术或因前列腺癌接受根治性前列腺切除术的患者。我们使用逻辑回归分析，对进行淋巴结清扫的概率进行校正，估计淋巴结清扫与肺栓塞和深静脉血栓形成（DVT）之间的关联比值比。
总共纳入了6069例行根治性膀胱切除术的患者和36911例行根治性前列腺切除术的患者。根治性膀胱切除术后行淋巴结清扫时，肺栓塞和DVT的风险分别为1.89%和2.29%，未行淋巴结清扫时分别为1.99%和2.35%。根治性前列腺切除术后行淋巴结清扫时，肺栓塞和DVT的风险分别为0.97%和1.36%，未行淋巴结清扫时分别为0.42%和0.49%。根治性膀胱切除术中的盆腔淋巴结清扫与肺栓塞（比值比0.99；95%置信区间0.65 - 1.51）或DVT（比值比0.99；95%置信区间0.68 - 1.48）无关，而根治性前列腺切除术中的淋巴结清扫与肺栓塞（比值比2.29；95%置信区间1.67 - 3.09）和DVT（比值比2.95；95%置信区间2.27 - 3.85）的较高比值比相关。
盆腔淋巴结清扫未增加膀胱切除术后静脉血栓栓塞的风险，而我们发现根治性前列腺切除术联合淋巴结清扫与静脉血栓栓塞事件的相对风险增加有关。
