Risk Factor of Deep Vein Thrombosis Development among Gynecologic Cancer Patients

Background: Venous thromboembolism (VTE) incidence and its associated risk factors have not been well established. This study was conducted to evaluate risk factors associated with DVT in gynecologic cancer patients. Materials and methods: This retrospective case-control study included patients diagnosed with gynecologic cancer with or without DVT between January 2002 and December 2016 at Rajavithi Hospital. The presence of DVT was confirmed by either color Doppler ultrasonography or computed tomography scan. Patients’ demographic data, type, and stage of cancer, and treatment modalities were considered. Univariate analysis and multivariate logistic regression analysis were used to calculate odds ratios (OR) and determine independent risk factors of DVT. Results: Over a 14-year-period, 242 patients (2.85%) with DVT were identified in a total 8476 gynecologic cancer patients. 156 (33.3%) cases with DVT were matched with 312 (66.7%) cases without DVT with respect to type of cancer. Among patients with DVT, the median time to diagnosis DVT was 4 months (IQR 2-12 months). After diagnosis of cancer, most of cases (89.5%) had symptomatic DVT mostly (49%) detected in ovarian cancer patients. Following multivariate analysis, 3 significant predictors of DVT development were identified, namely being in advanced-stage of cancer (OR 7.22; 95%CI 4.62-11.28, p 0.001), undergoing lymphadenectomy (OR 1.90; 95%CI 1.21-2.98, p=0.005), and suffering from massive operative blood loss (≥1500 ml; OR 2.09; 95%CI 1.12-3.91, p=0.021). Conclusion: Awareness of DVT is the best way to prevent VTE. Therefore, an appropriate prophylaxis and closed monitoring of gynecologic cancer patients with advanced-stage cancer, those who underwent lymphadenectomy, and those suffering from massive operative blood loss should be mandatory to managethromboembolism complications.