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Komatsu H, Shimada M, Osaku D, Deura I, Sato S, Oishi T, Harada T. Deep vein thrombosis and serum D-dimer after pelvic lymphadenectomy in gynecological cancer. Int J Gynecol Cancer 2020; 30:860-864. [PMID: 32276932 DOI: 10.1136/ijgc-2019-000914] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 03/09/2020] [Accepted: 03/16/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Venous thromboembolism prevention during the perioperative period requires comprehensive risk-level assessment. The aim of this study was to evaluate the incidence of deep vein thrombosis and to assess the cut-off levels of serum D-dimer as a screening strategy for deep vein thrombosis during the perioperative period. METHODS A total of 205 patients (ovarian cancer: 68, endometrial cancer: 76, cervical cancer: 61) who underwent gynecological surgery, including retroperitoneal lymph node dissection, were enrolled. We retrospectively analyzed the data on the cut-off value of D-dimer assessed using area under the receiver operating characteristic curve preoperatively, and 2 or 3 months, postoperatively. All patients underwent leg vein ultrasonography regardless of the serum D-dimer level. Furthermore, CT scans were performed to evaluate both disease status and venous thromboembolism, including pulmonary thromboembolism. Statistical analyzes were performed using the Mann-Whitney U-test (D-dimer values of each cancer), Chi-square test, Fisher's exact test (incidence of deep vein thrombosis), and one-way analysis of variance (patient characteristics). RESULTS A total of 205 patients (ovarian cancer: 68, endometrial cancer: 76, cervical cancer: 61) who underwent gynecological surgery, including retroperitoneal lymph node dissection, were included in the analysis. Deep vein thrombosis rates were significantly higher in patients with ovarian cancer (P<0.001). The postoperative D-dimer value was significantly higher than the preoperative value. Postoperative D-dimer values were also significantly higher in patients who received adjuvant chemotherapy (P=0.001). The cut-off value of D-dimer was 1.55 µg/mL preoperatively (sensitivity, 48.0%; specificity, 94.1%), and this value was higher postoperatively, at 1.95 µg/mL (sensitivity, 37.0%; specificity, 90.9%). CONCLUSION Postoperative D-dimer values are higher not only after surgery but also in patients who received adjuvant chemotherapy. The cut-off value of D-dimer at 2 or 3 months postoperatively was higher than preoperative value.
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Affiliation(s)
- Hiroaki Komatsu
- Obstetrics and Gynecology, Tottori University, Yonago, Tottori, Japan
| | - Muneaki Shimada
- Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Daiken Osaku
- Obstetrics and Gynecology, Tottori University, Yonago, Tottori, Japan
| | - Imari Deura
- Obstetrics and Gynecology, Sei Marianna Ika Daigaku Yokohama-shi Seibu Byoin, Yokohama, Kanagawa, Japan
| | - Shinya Sato
- Obstetrics and Gynecology, Tottori University, Yonago, Tottori, Japan
| | - Tetsuro Oishi
- Obstetrics and Gynecology, Tottori University, Yonago, Tottori, Japan
| | - Tasuku Harada
- Obstetrics and Gynecology, Tottori University, Yonago, Tottori, Japan
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Li M, Guo Q, Hu W. Incidence, risk factors, and outcomes of venous thromboembolism after oncologic surgery: A systematic review and meta-analysis. Thromb Res 2018; 173:48-56. [PMID: 30471508 DOI: 10.1016/j.thromres.2018.11.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 11/06/2018] [Accepted: 11/14/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND The risk and prognosis of VTE associated with oncologic surgery need to be quantified to guide patient management. We aimed to examine the availability of data and to report the incidence of venous thromboembolism (VTE) in cancer patients after surgery, as well as the clinical outcomes of VTE following oncologic surgery. METHODS We searched multiple databases for terms related to VTE after oncologic surgery from inception to November 1, 2017. A random-effects meta-analysis was done to calculate the pooled incidence of VTE. RESULTS Of the 8611 citations identified, 136 studies including 1,481,659 patients met the eligibility criteria. The overall incidence of VTE was estimated to be 2.3% (95% CI 2.1-2.5). Bone and soft tissue cancer (10.6%, 95% CI 2.9-18.2) and lung cancer (8.1%, 95% CI 3.7-12.6) were associated with the highest and second highest risk of postoperative VTE, respectively. Age (standardized mean difference [SMD] = 0.46, 95% CI 0.40-0.53; I2 = 93.8%), radiation (OR 1.29, 95% CI 1.03-1.62; I2 = 34.6%), transfusion (OR 1.96, 95% CI 1.48-2.59; I2 = 57.0%), and operative time (SMD = 1.12, 95% CI 1.07-1.16; I2 = 100%) were possible risk factors for postoperative VTE. Patients with VTE versus those without had increased odds of all-cause fatal events (11.15, 95% CI 4.07-30.56; I2 = 92.0%). CONCLUSIONS The risk of VTE after oncologic surgery remains high, and this risk varied according to the cancer type, study region, surgical location, and thromboprophylactic strategy. VTE is associated with increased mortality at the early stage of cancer surgery.
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Affiliation(s)
- Mao Li
- Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qiang Guo
- Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Weiming Hu
- Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
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Du H, Chen J. [Occurrence of Venous Thromboembolism in Patients with Lung Cancer
and Its Anticoagulant Therapy]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2018; 21:784-789. [PMID: 30309431 PMCID: PMC6189020 DOI: 10.3779/j.issn.1009-3419.2018.10.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
目前,肺癌的发病率和死亡率在全世界范围内居首位。静脉血栓栓塞症(venous thromboembolism, VTE)是一种公认的肺癌并发症,也是肺癌患者的主要死因之一。癌症自身因素、患者自身因素以及治疗相关因素都是导致肺癌患者发生VTE的主要原因。肿瘤细胞可产生组织因子(tissue factor, TF)、癌性促凝物质(cancer procoagulant, CP)、炎症因子和细胞因子,从而直接激活凝血;其中TF过度表达是肿瘤患者血栓形成的主要机制之一。2016年美国胸外科医师协会(American College of Chest Physicians, ACCP)发布的第10版肿瘤患者VTE防治指南(AT-10)指出,抗凝治疗是肺癌患者合并VTE的基本治疗措施;其中低分子肝素(low molecular-weight-heparin, LWMH)被认为是首选的抗凝药物,但要注意出血风险。
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Affiliation(s)
- Hui Du
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jun Chen
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
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Alanazi OA, El-Fetoh NMA, Mohammed NA, Alanizy TMA, Alanazi YW, Alanazi MS, Alrwaili AA, Alruwaili AH, Alanazi AH, Alanazi AS. Deep Venous Thrombosis among hypertensive patients in King Abdulaziz University (KAU) Hospital, Jeddah, Kingdom of Saudi Arabia. Electron Physician 2017; 9:5472-5477. [PMID: 29238486 PMCID: PMC5718850 DOI: 10.19082/5472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 08/22/2017] [Indexed: 12/20/2022] Open
Abstract
Background Deep venous thrombosis (DVT) is a frequent cardiovascular disorder. It is among the main causes of morbidity and mortality among hospitalized patients and, at the same time, can be easily avoided. Studies clarified that there are a variety of factors which can be significantly associated with the development of DVT in hospitalized patients. Objective to identify frequency and factors associated with occurrence of DVT among hypertensive patients referred to KAU hospital, Jeddah, Kingdom of Saudi Arabia. Methods A cross-sectional hospital-based study was conducted from October 2016 to March, 2017. All hypertensive patients referred to or admitted to the hospital departments and who were suspected to have DVT and subjected to Doppler examination were included in the study. A questionnaire was designed to obtain data about DVT frequency among participants and factors associated with the development of DVT among them. Data was collected through face to face interviews of patients included in the study. Results DVT was detected in 13.5 % of the studied hypertensive patients. Increased age and gender had no significant association with the development of DVT among the studied patients. In addition, other studied factors and comorbidities had no significant role in DVT development among the study participants. Conclusion Knowing the most common risk factors and their significance in developing DVT is essential for early detection of DVT to prevent it, especially for hypertensive patients. Awareness campaigns should be held more often in different neighborhoods of the city.
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Affiliation(s)
- Omar Ayed Alanazi
- Intern, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia
| | - Nagah Mohamed Abo El-Fetoh
- M.D., Associate Professor, Department of Public Health and Community Medicine, Faculty of Medicine and Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia.,Sohag College of Medicine, Sohag University, Egypt
| | - Nesreen Ali Mohammed
- Lecturer of Public Health and Community Medicine, Faculty of Medicine, Sohag Faculty of Medicine, Sohag University, Egypt
| | | | - Yasir Wadi Alanazi
- Intern, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia
| | | | | | | | | | - Ahmed Saad Alanazi
- Student, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia
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Alotaibi HK, Abo el-Fetoh NM, MenwerAlanazi A, Alanazi OA, Alanazi AB, Alhowaish MA, Alzahrani HSB, Alshammari MA, ALrashidi RF, Alblowi TM, Alqahtani SJ, Almaashi FS. Deep venous thrombosis among diabetic patients in King Abdulaziz University (KAU) Hospital, Jeddah, Kingdom of Saudi Arabia. Electron Physician 2017; 9:5185-5190. [PMID: 29038695 PMCID: PMC5633211 DOI: 10.19082/5185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 08/23/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Deep venous thrombosis (DVT) is a major cause of morbidity and mortality among hospitalized patients worldwide and, simultaneously, the most preventable. Studies revealed several risk factors of deep venous thrombosis in hospitalized patients. OBJECTIVE to identify frequency and factors associated with occurrence of deep venous thrombosis among diabetic patients referred to King Abdulaziz University (KAU) Hospital, Jeddah, Kingdom of Saudi Arabia. METHODS This cross-sectional hospital-based study was conducted from June to December, 2016. All diabetic patients referred to the hospital departments and who were suspected to have deep venous thrombosis (DVT) and subjected to Doppler examination were included in the study. A questionnaire was designed to obtain data about deep venous thrombosis frequency among participants and factors associated with the development of deep venous thrombosis among them. Data was collected through face to face interviews with patients included in the study. We used SPSS version 16 for data analysis through descriptive statistics and Chi-square test. RESULTS DVT was detected in 14.7 % of the examined patients. There were significant and positive associations between age and DVT (X2=10.13, p=0.03) and between ischemic heart disease and DVT (X2=1.628, p=0.043) with the development of deep venous thrombosis among the studied patients. On the other hand, gender, other comorbidities, history of previous DVT, being bed ridden and using orthopedic casting were not significantly associated with the occurrence of deep venous thrombosis among the participants. CONCLUSION DVT development rate among the participants was 14.7 %. Aging was significantly associated with DVT occurrence. Most of the studied factors and comorbidities had no significant role in DVT development among participants and only ischemic heart disease was significantly associated with DVT development.
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Affiliation(s)
- Hanan Khalid Alotaibi
- Intern, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia
| | - Nagah Mohamed Abo el-Fetoh
- Associate professor, Community Medicine Department, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia
| | - Aseel MenwerAlanazi
- Intern, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia
| | - Omar Ayed Alanazi
- Intern, Faculty of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia
| | | | | | | | | | | | | | | | - Fatin Salem Almaashi
- Medical Intern, Faculty of Medicine, Hail University, Hail, Kingdom of Saudi Arabia
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