Effect of perioperative venous thromboembolism on survival in ovarian, primary peritoneal, and fallopian tube cancer.
OBJECTIVE
Venous thromboembolism (VTE) affects 15% of cancer patients and is the second leading cause of death in hospitalized cancer patients. The purpose of this study was to describe the overall survival of patients with ovarian, primary peritoneal, and fallopian tube cancers treated for VTE within 30 days of initial surgery.


METHODS
We reviewed the medical records of all patients who developed VTE within 30 days of primary surgery for stage I-IV epithelial ovarian, tubal, or primary peritoneal cancer at our institution from 1/99 to 4/05. Standard statistical tests were used.


RESULTS
Fifty-seven (10%) of 559 patients developed VTE within 30 days of initial surgery. There were no deaths from VTE within 30 days of surgery. With a median follow-up of 2.8 years (range, 0.11-7.3 years), the median overall survival for the entire cohort was 5.9 years (95% CI, 4.6-NR). The proportion of advanced-stage (III-IV) patients within the VTE group compared to the group with no VTE was higher (90% versus 72%; P=0.0078), as was the proportion of patients with ascites compared to those with none (74% versus 54%; P=0.0045), and the proportion of patients with residual disease >1 cm compared to those with <or=1 cm (37% versus 19%; P=0.0021). On multivariate analysis, advanced stage (P<0.0001), the presence of ascites (P=0.0210), and residual disease>1 cm (P<0.0001) were significant predictors of poorer overall survival. VTE within 30 days of surgery was not found to be independently associated with overall survival (hazard ratio, 1.1; 95% CI, 0.71-1.7); P=0.65).


CONCLUSIONS
Previous studies have shown that a significant number of patients undergoing primary surgery for ovarian cancer will develop postoperative VTE, especially those undergoing extensive cytoreductive procedures. In this large cohort of patients with ovarian, tubal, or primary peritoneal cancer, we found no detrimental effects of perioperative VTE on overall survival.
Black
Destin
D
Gynecology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
Iasonos
Alexia
A
Ahmed
Hina
H
Chi
Dennis S
DS
Barakat
Richard R
RR
Abu-Rustum
Nadeem R
NR
D000328:Adult; D000368:Aged; D005185:Fallopian Tube Neoplasms / Q000150:complications* / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000401:mortality; D010051:Ovarian Neoplasms / Q000150:complications* / Q000401:mortality* / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000150:complications* / Q000401:mortality* / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D015996:Survival Rate; D020246:Venous Thrombosis / Q000150:complications*