Association of clear cell carcinoma of the endometrium with a high rate of venous thromboembolism.
OBJECTIVE
To document the rate of clinically significant venous thromboembolism (VTE) in patients with clear cell carcinoma of the endometrium (CCC-E).


METHODS
Institutional review board permission was obtained to identify all cases of CCC-E between 1994 and 2004. Controls with high grade endometrial cancers were matched for stage, age and date of diagnosis.


RESULTS
Complete data were available for 29. Age ranged from 38 to 85 (mean, 64.6) years. Thirty-five percent of the patients had stage I tumors, 10% stage II, 27.5% stage III and 27.5% stage IV tumors. Fifty-eight matched controls were selected. Overall there were 18 VTE events: 10 (34.5%) in patients with CCC-E and 8 (13.8%) in the controls (OR = 3.68, p = 0.032). More VTE occurred in patients with stage III/IV disease (n = 16) than those with early stage (n = 2). VTE in patients with CCC-E occurred at presentation or with disease recurrence rather than in the postoperative period (8 vs. 1). Among patients with CCC-E, VTE had an adverse effect on survival, with a hazard ratio of 3.65 (95% CI, 3.14-4.16; p = 0.011).


CONCLUSIONS
Patients with CCC-E have greater risk of VTE than patients with other high-risk endometrial cancers. Consideration should be given to extended prophylaxis in patients with CCC-E to prevent VTE.
Division of Gynecologic Oncology, Biostatistics Center, Massachusetts General Hospital, Boston, USA.
Lisa
L
Lee
Leslie
L
Garrett
Hang
H
Lee
Esther
E
Oliva
Neil
N
Horowitz
Linda R
LR
Duska
D018262:Adenocarcinoma, Clear Cell / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011322:Primary Prevention; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology
D005343:Fibrinolytic Agents