title: Incidence of and risk factors for venous thromboembolism during surgical treatment for esophageal cancer: a single-institution study.
abstract: OBJECTIVE
  During the treatment of esophageal cancer with curative intent, patients sometimes experience deep vein thrombosis, pulmonary embolism or a central venous catheter-associated thrombus. In this study, we retrospectively reviewed our new-onset esophageal cancer patients and determined the incidence of venous thromboembolism (VTE), the location of the thrombus and the risk factors for VTE.
  
  
  METHODS
  One hundred and fifty-three patients undergoing treatment with curative intent were reviewed as candidates. The existence of VTE was assessed from the neck to the pelvis with computed tomography at the initial visit, after neo-adjuvant chemotherapy and postoperatively.
  
  
  RESULTS
  Twenty-one VTE events (13.7%) were observed, 16 of which (76.2%) were suggested to be associated with central venous catheterization. When both the pre-therapeutic plasma fibrinogen and C-reactive protein levels were high (≥350 mg/dL and ≥0.2 µg/mL, respectively), the risk of preoperative VTE and overall VTE were significantly higher than normal (p = 0.040, and p = 0.030, respectively). Adenocarcinoma histology and neck lymph node dissection were the independent risk factors that significantly increased the overall risk of VTE (p = 0.015, and p = 0.017, respectively).
  
  
  CONCLUSIONS
  This study revealed that the pre-therapeutic plasma fibrinogen level, C-reactive protein level, adenocarcinoma histology and neck lymph node dissection are the risk factors for venous thromboembolism in patients with esophageal cancer undergoing treatment with curative intent.
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kato
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. htakeuchi@a6.keio.jp.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Takeuchi
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Matsuda
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kawakubo
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Tai
authors.initials: T
authors.lastname: Omori
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D062905:Central Venous Catheters / Q000009:adverse effects; D004938:Esophageal Neoplasms / Q000601:surgery*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control
chemical_list: D005340:Fibrinogen; D002097:C-Reactive Protein
keywords: Esophageal cancer; Esophagectomy; Venous thromboembolism