Incidence and Risk Factors for Postoperative Venous Thromboembolism in Patients with Endometrial Cancer: Systematic Review and Meta-analysis

Abstract

Background: Venous Thromboembolism (VTE) is a leading reason of morbidity and mortality in endometrial cancer patients. There is no meta-analysis available on this topic so far. In order to identify relevant risk factors contributing to VTE and form strategies to prevent VTE, we conducted the present study to quantitatively analyze the data from studies with the incidence and risk factors among cases with endometrial cancer.Methods: PubMed, Embase and CNKI were searched for papers containing the key words “thromboembolism” “endometrial cancer” and their variants. Studies selection, data extraction, quality assessment of eligible studies were performed independently by two reviewers. Meta-analyses were conducted to determine postoperative VTE incidence rate and risk factors in endometrial cancer. Sensitivity analysis was used to verify the robustness of the results in the present study.Results: 8 studies were included in this meta-analysis totally. The pooled incidence rate for postoperative VTE was 7% (95% CI, 0.04 –0.09).The presence of age>60 (OR, 2.26), tumor size in uterine cavity(＞60mm) (OR, 5.68), tumor extension (CT/MRI) (OR, 5.59), FIGO stage (OR, 2.92), massive ascites (OR, 3.78), clear cell cancer (OR, 4.78) and CA125(＞35U/ml) (OR, 5.05) increase the likelihood of having postoperative VTE remarkably. Conclusions: The present study revealed that VTE is a prevalent complication in postoperative patients with endometrial cancer. The patients with the following risk factor including female elderly, large size of tumor, advanced endometrial cancer，massive ascites , elevated CA125 and special histology should be altered VTE occurrence.