How Common is Venous Thromboembolism During Neoadjuvant Treatment for Ovarian Cancer?
BACKGROUND AND PURPOSE:
There is a 10-22% incidence of venous thromboembolism (VTE) in patients with ovarian cancer and is a hypercoagulable state
Most efforts to reduce the risk of VTE have focused on the postoperative period
Neoadjuvant chemotherapy (treatment prior to surgery) is becoming more common, and may confer high risk for DVT
This study by Greco et al. (Obstetrics & Gynecology, 2017) sought to identify the risk and timing of VTE in patients with ovarian, fallopian, or primary peritoneal cancer undergoing neoadjuvant chemotherapy
Retrospective Cohort Study
112 women with ovarian cancer undergoing neoadjuvant chemotherapy were included in the analysis
30 women experienced a VTE (26.8%, 95% CI 19.3-35.9%)
13 during neoadjuvant chemotherapy (11.6%, 95% CI 6.8-19.1%)
Six following surgery (5.4%, 95% CI 2.4-11.5%)
11 during adjuvant chemotherapy (9.9%, 95% CI 5.5-17%)
50% (2/4) of the patients with clear cell histology experienced a VTE
> 25% of women undergoing neoadjuvant chemotherapy for ovarian cancer experienced a VTE
10% during neoadjuvant chemotherapy
10% during adjuvant chemotherapy after debulking surgery
Patients with ovarian cancer undergoing neoadjuvant chemotherapy are at very high risk for VTE
The authors recommend increased focus on anticoagulation during the neoadjuvant and adjuvant treatment period and that randomized controlled trials are necessary to determine appropriate anticoagulant regimens
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