Venous Thromboembolism in Gynecological Malignancy

Cohen, Abigail; Lim, Chung Sim; Davies, Alun H.

doi:10.1097/igc.0000000000001111

Cited by 51 publications

(32 citation statements)

References 57 publications

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“…Of these, lymphocele is one of the most common postoperative complications in that it leads to the occurrence of VTE by venous compression [54,55]. According to a review of the literature, VTE occurred after lymphadectomy at an estimated incidence of 0.8-25% [56][57][58]. This is also seen in our results.…”

Section: Discussionsupporting

confidence: 83%

Predictive Factors of Deep Vein Thrombosis in Gynecologic Cancer Survivors with Lower Extremity Edema: A Single-Center and Retrospective Study

Kim

Park

et al. 2020

Healthcare

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This study was conducted to examine predictive factors of deep vein thrombosis (DVT) in gynecologic cancer survivors with lower extremity edema (LEE). In the current single-center, retrospective study, there was a total of 315 eligible patients, including 80 patients with DVT and 235 without DVT. They were therefore divided into two groups: the DVT group (n = 80) and the non-DVT group (n = 235). Then, baseline and clinical characteristics of the patients were compared between the two groups. In our study, distant organ metastasis, advanced stage, lymphadectomy, and amount of intraoperative blood loss had a positive predictive value for the occurrence of DVT in gynecologic cancer survivors presenting LEE. In conclusion, our results indicate that it is necessary to consider the possibility of LEE arising from DVT in gynecologic cancer survivors with advanced-stage cancer, distant organ metastasis, lymphadectomy, and intraoperative blood loss over 1500 mL.

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Section: Discussionsupporting

confidence: 83%

Predictive Factors of Deep Vein Thrombosis in Gynecologic Cancer Survivors with Lower Extremity Edema: A Single-Center and Retrospective Study

Kim

Park

et al. 2020

Healthcare

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“…It is understandable why regional fibrosis and post-therapy pelvic tissue ischemia account for the parietal dysfunction at the level of the ureteral wall and also for the venous or lymphatic walls, explaining complications such as DVT, bowel obstruction, hydronephrosis, or lymphedema, being directly proportional to the amount of aggression. [ 6 , 12 , 13 , 15 , 22 , 23 ] A study done by Kim et al [ 9 ] showed that a lower incidence of pelvic lymphocele can be seen if postoperative radiotherapy is not applied, suggesting a more cautious choice of adjuvant treatment. In only 1 study, performed by Achouri et al, [ 16 ] did adjuvant radiotherapy have a beneficial effect, by significantly reducing number of symptomatic pelvic lymphocele, but this study does not mention whether radiotherapy lowers the number of lymphocele altogether.…”

Section: Discussionmentioning

confidence: 99%

The role of pelvic lymphocele in the development of early postoperative complications

Neagoe

Ionică²,

Mazilu³

2018

Medicine

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With the increasing incidence of gynecologic malignancy, radical hysterectomy represents an important part of the adequate treatment of these patients. The pelvic lymphocele is a known side effect of pelvic and para-aortic lymphadenectomy. The aim of our study was to assess the role of the lymphocele in the development of early postoperative complications.A single-center, retrospective analysis between January 2000 and May 2017 revealed 1867 patients with cervical and endometrial cancer, treated through radical or modified radical hysterectomy and pelvic lymphadenectomy. Postoperative complications and the occurrence of pelvic lymphocele were evaluated.Approximately 47.6% of patients were diagnosed with pelvic lymphocele, with only 5.2% being symptomatic. Early postoperative complications rate recorded an incidence of 8.1%, occurring more frequent if lymphocele were present (P < .001). The pelvic lymphocele represented, in univariate analysis, a risk factor for the development of pelvic abscesses, but not for deep vein thrombosis, lymphedema, or bowel obstruction. Hydronephrosis was found to be significantly correlated with the pelvic lymphocele, but we believe this urological complication to have a different underlining mechanism. Neoadjuvant radiotherapy represented in both uni- and multivariate analysis a risk factor for the occurrence of postoperative complications.In the postoperative context of oncogynecological surgery, pelvic lymphocele occur at high rates, representing a statistical risk factor for hydronephrosis and pelvic abscesses, with neoadjuvant radiotherapy being an independent risk factor for early postoperative complications.

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“…Thromboembolism is one of the most common complications of malignancy that can occur before or after the diagnosis of Unusual presentation of ovarian cancer cancer. 7 A hypercoagulable state can occur in patients with cancer due to interactions between monocyte/macrophages with malignant cells causing the release of tumor factors such as tumor necrosis factor and interleukins-1 and -6. 11 This leads to endothelial damage and sloughing of endothelial cells, which acts as a thrombogenic surface to activate intrinsic and extrinsic coagulation factors that convert prothrombin to thrombin to generate thrombi.…”

Section: Discussionmentioning

confidence: 99%

“…5 Cancers associated with a higher incidence of stroke are lung, pancreatic, and colorectal cancers. 3,6 VTE disease (pulmonary embolism [PE] and deep vein thrombosis [DVT]) are significantly associated with ovarian cancer 7 and adversely impact patient survival. [7][8][9][10] This case report outlines the discovery of occult ovarian cancer in a patient who exhibited acute cerebrovascular events with an incidental detection of patent foramen ovale (PFO).…”

mentioning

confidence: 99%

Ovarian Cancer Presenting as Cryptogenic Stroke from Patent Foramen Ovale

Potugari

Priyanka²,

Komanapalli

et al. 2019

Clin Med Res

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A woman, aged 52 years, experienced severe headache, confusion, nausea, dizziness, and diplopia for three days. Magnetic resonance imaging of the brain showed multiple acute and subacute infarcts suggestive of embolic events. Dermatological examination was notable for splinter hemorrhages and macular patches on the fingernails and feet, respectively. Further diagnostic imaging of the chest and abdomen revealed pulmonary emboli and an ovarian mass with omental deposits and splenic infarcts. Fine-needle aspiration cytology and surgery confirmed a diagnosis of high-grade serous adenocarcinoma of the ovary with clear cell features. Extensive evaluation for malignancy should be considered on a case-by-case basis for patients with thromboembolic disease and an initial negative diagnostic evaluation for stroke. Consideration of patent foramen ovale closure is reasonable in patients with malignancy who are at risk for recurrent strokes.

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Venous Thromboembolism in Gynecological Malignancy

Cited by 51 publications

References 57 publications

Predictive Factors of Deep Vein Thrombosis in Gynecologic Cancer Survivors with Lower Extremity Edema: A Single-Center and Retrospective Study

Predictive Factors of Deep Vein Thrombosis in Gynecologic Cancer Survivors with Lower Extremity Edema: A Single-Center and Retrospective Study

The role of pelvic lymphocele in the development of early postoperative complications

Ovarian Cancer Presenting as Cryptogenic Stroke from Patent Foramen Ovale

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