title: Thromboembolic events in patients with cervical carcinoma: Incidence and effect on survival.
abstract: OBJECTIVE
  The purpose of this study was to determine whether thromboembolic events (TE) in cervical cancer patients are associated with survival by comparing the survival of patients with and without thromboembolic events over a seven year period.
  
  
  METHODS
  Utilizing a retrospective chart review we identified patients with any diagnosis of a TE, associated risk factors for TE development and overall survival. We also collected clinico-pathological data including stage, histology, height, weight, smoking history, radiation and chemotherapy treatment data and the temporal relationship of the development of TE to the time of cancer diagnosis. Data sources included the University of Iowa Hospitals and Clinics (UIHC) Tumor Registry and the UIHC Gynecologic Oncology Tumor Data Base as well as a search of UIHC medical record data bases using ICD-9 codes to initially identify all patients diagnosed with cervical carcinoma.
  
  
  RESULTS
  In this study, the incidence of TE in cervical cancer patients was 11.7%. There was a clear and significant difference in survival between patients with and without TE. We identified an association between TE and stage, chemotherapy, brachytherapy, and radiation therapy.
  
  
  CONCLUSIONS
  The major findings of our study are a significant incidence of thromboembolism in patients with cervical cancer, and a significant decrease in survival in patients who experience thromboembolism at presentation or during treatment. Deaths in these patients were overwhelmingly related to progressive cancer rather than the TE itself, suggesting that this adverse prognostic event may be related to aggressive tumor biology.
authors.affiliation: Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Holden Comprehensive Cancer Center, Iowa City, IA 52242, USA. geraldine-jacobson@uiowa.edu
authors.forename: Geraldine
authors.initials: G
authors.lastname: Jacobson
authors.forename: John
authors.initials: J
authors.lastname: Lammli
authors.forename: Gideon
authors.initials: G
authors.lastname: Zamba
authors.forename: Lei
authors.initials: L
authors.lastname: Hua
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Goodheart
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D013923:Thromboembolism / Q000453:epidemiology* / Q000401:mortality; D002583:Uterine Cervical Neoplasms / Q000097:blood* / Q000401:mortality; D055815:Young Adult