title: Preliminary study to identify cancer patients at high risk of venous thrombosis following major surgery.
abstract: This study investigated whether the pre-surgical plasma levels of TAT and F1 + 2 of patients undergoing major surgery for localized tumours could identify patients at higher risk of thrombosis, and how heparin prophylaxis affected in vivo coagulation after cancer surgery. We measured the pre- and post-operative levels of TAT, F1 + 2, total factor VII (FVIIt) and zymogen FVII (FVIIz) in 117 cancer patients, with and without heparin prophylaxis. The end points of this study were DVT, initially detected by 125I-fibrinogen uptake test and confirmed by ascending venography. Pre-operative [TAT] and [F1 + 2] of the cancer patients were significantly higher than those of age-matched control subjects (n = 50) (P < 0.005 and P < 0.05, respectively); pre-operative [FVII] was not significantly different. One of the 83 patients receiving prophylaxis, and 8/34 not receiving prophylaxis developed post-operative DVT. Of the parameters evaluated, only the pre-operative [TAT] > 3.5 ng/ml identified patients at higher risk for post-operative DVT. Heparin reduced plasma TAT levels and FVII consumption following surgery, suggesting that heparin modulates coagulation associated with cancer surgery. The results of this study also suggest that the pre-operative [TAT] may identify patients with higher risk for post-operative DVT.
authors.affiliation: Haematology Department of Ospedali Riuniti, Bergamo, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Falanga
authors.forename: F A
authors.initials: FA
authors.lastname: Ofosu
authors.forename: S
authors.initials: S
authors.lastname: Cortelazzo
authors.forename: F
authors.initials: F
authors.lastname: Delaini
authors.forename: R
authors.initials: R
authors.lastname: Consonni
authors.forename: R
authors.initials: R
authors.lastname: Caccia
authors.forename: S
authors.initials: S
authors.lastname: Longatti
authors.forename: D
authors.initials: D
authors.lastname: Maran
authors.forename: F
authors.initials: F
authors.lastname: Rodeghiero
authors.forename: E
authors.initials: E
authors.lastname: Pogliani
mesh_terms: D000328:Adult; D000990:Antithrombin III / Q000378:metabolism; D005167:Factor VII / Q000378:metabolism; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery*; D010447:Peptide Hydrolases / Q000378:metabolism; D011183:Postoperative Complications; D011300:Preoperative Care; D018570:Risk Assessment; D013924:Thrombophlebitis / Q000097:blood / Q000209:etiology* / Q000517:prevention & control
chemical_list: C046193:antithrombin III-protease complex; D000990:Antithrombin III; D005167:Factor VII; D006493:Heparin; D010447:Peptide Hydrolases