Uterine Serous Carcinoma Patients Have Long Risk of VTE

Patients with uterine serous carcinoma are at an increased risk of developing venous thromboembolism (VTE) not just immediately following operation but months after surgery, according to a recent study. 

Researchers retrospectively assessed 413 women diagnosed with uterine serous carcinoma between 1999 and 2016 at a single institution; 70 patients (17%) developed VTE after a median of 7.2 months from presentation to VTE and 13.2 months from surgery to VTE. Of the 70 VTE patients, 59 (84%) were diagnosed either before surgery or more than six weeks following surgery, and 22 (31%) were on chemotherapy when they were diagnosed. Median Khorana score for patients diagnosed while on chemotherapy was one; pharmacologic prophylaxis is recommended in patients with a score of three or higher. Cancer stages III (hazard ratio [HR] 3.20, 95% CI 1.54–6.64) and IV (HR 8.68, 95% CI 4.50–16.73) and hypertensive (HR 2.29, 95% CI 1.08–4.85) or cardiovascular diseases (HR 1.82, 95% CI 1.05–3.13) were associated with time to VTE. 

“Although this is a retrospective study, it generates the hypothesis that venous thromboembolism prophylaxis may be beneficial in women with active uterine serous carcinoma, at least while receiving treatment such as neoadjuvant or adjuvant chemotherapy,” the study authors wrote. 

“Ours is not the first report to posit that currently available venous thromboembolism risk stratification tools are of limited utility in gynecologic oncology patients,” they added. 

The researchers called for larger prospective studies to confirm the benefits of VTE prophylaxis while cancer patients are actively being treated. 

Long-Term Risk of Venous Thromboembolism in Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study. 

Venous Thromboembolism in Patients with Sarcoma: A Retrospective Study 

Association of Aspirin With Prevention of Venous Thromboembolism in Patients After Total Knee Arthroplasty Compared With Other Anticoagulants: A Noninferiority Analysis 

Validation of simplified PESI score for identification of low-risk patients with pulmonary embolism: From the COMMAND VTE Registry 

Sources: Oncology PracticeObstetrics & Gynecology