title: Venous thromboembolism at time of diagnosis of ovarian cancer: Survival differs in symptomatic and asymptomatic cases.
abstract: OBJECTIVE
  To determine the impact on survival of symptomatic and asymptomatic venous thromboembolism (VTE) at time of diagnosis of primary ovarian malignancy.
  
  
  METHODS
  The clinical records of 397 consecutive cases of primary ovarian malignancy were studied. Clinical, pathological and survival data were obtained.
  
  
  CONCLUSIONS
  Of 397 cases, 19 (4.8%) were found to have VTE at diagnosis, of which 63.2% (n=12) were asymptomatic. VTE was significantly associated with reduced overall median survival (28 vs. 45 months, p=0.004). Decreased survival was associated with symptomatic VTE compared to patients with asymptomatic VTE (21 vs. 36 months, p=0.02) whose survival was similar to that of patients without VTE. Decreased survival remained significant in symptomatic patients after controlling for stage of disease at diagnosis, cytoreductive status and adjuvant chemotherapy use. Overall these data suggest for the first time that symptomatic but not asymptomatic VTE prior to primary treatment of ovarian cancer is an independent adverse prognostic factor.
authors.affiliation: Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, Lanesborough Wing, St. George's Hospital, Blackshaw Road, London, SW17 0QT, United Kingdom. Electronic address: owenheath@doctors.org.uk.
authors.forename: Owen Mortimer
authors.initials: OM
authors.lastname: Heath
authors.affiliation: Department of Gynaecological Oncology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, United Kingdom.
authors.forename: Heleen J
authors.initials: HJ
authors.lastname: van Beekhuizen
authors.affiliation: Department of Gynaecological Oncology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, United Kingdom.
authors.forename: Vivek
authors.initials: V
authors.lastname: Nama
authors.affiliation: Department of Gynaecological Oncology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, United Kingdom.
authors.forename: Desiree
authors.initials: D
authors.lastname: Kolomainen
authors.affiliation: Department of Gynaecological Oncology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, United Kingdom.
authors.forename: Marielle A E
authors.initials: MAE
authors.lastname: Nobbenhuis
authors.affiliation: Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, Lanesborough Wing, St. George's Hospital, Blackshaw Road, London, SW17 0QT, United Kingdom; Department of Gynaecological Oncology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, United Kingdom.
authors.forename: Thomas E J
authors.initials: TEJ
authors.lastname: Ind
authors.affiliation: Department of Radiology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, United Kingdom.
authors.forename: Syed A
authors.initials: SA
authors.lastname: Sohaib
authors.affiliation: Department of Oncology, St. Georges Hospital, Blackshaw Road, London, SW17 0QT, United Kingdom.
authors.forename: Fiona J
authors.initials: FJ
authors.lastname: Lofts
authors.affiliation: Department of Radiology, St. George's Hospital, Blackshaw Road, London, SW17 0QT, United Kingdom.
authors.forename: Sue
authors.initials: S
authors.lastname: Heenan
authors.affiliation: Department of Oncology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: Gore
authors.affiliation: Department of Oncology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, United Kingdom.
authors.forename: Susana
authors.initials: S
authors.lastname: Banerjee
authors.affiliation: Department of Oncology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, United Kingdom.
authors.forename: Stan B
authors.initials: SB
authors.lastname: Kaye
authors.affiliation: Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, Lanesborough Wing, St. George's Hospital, Blackshaw Road, London, SW17 0QT, United Kingdom; Department of Gynaecological Oncology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, United Kingdom.
authors.forename: Desmond P J
authors.initials: DPJ
authors.lastname: Barton
mesh_terms: D017677:Age Distribution; D000368:Aged; D058070:Asymptomatic Diseases / Q000401:mortality*; D015984:Causality; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D008131:London / Q000453:epidemiology; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D063189:Symptom Assessment / Q000706:statistics & numerical data; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy
keywords: Asymptomatic; Ovarian cancer; Recurrence; Survival; Symptomatic; Venous thromboembolism