Incidence and predictors of venous thromboembolism after surgery for gynecologic cancer

Objective: To describe the incidence, timing, and risk factors of venous thromboembolism (VTE) after surgery for gynecological cancer and to evaluate its effects of these events on survival. Methods: This was a retrospective analysis from January 2008 through December 2016 at a single center. Data were recorded on surgical procedures, patient demographic characteristics, type of malignancy and VTE, and mortality outcomes within 30 days after surgery. Significant variables related to VTE were evaluated using bivariate analysis, and Logistic regression models were used to assess risk factors for VTE. Results: The overall rate of postoperative VTE was 0.899% (36/4005) within 30 days after surgery. Of these rates, the rate in abdominal surgery was 1.56% (19/1220), and the rate in minimally invasive surgery (MIS) was 0.6% (17/2785). The median time from surgery to diagnosis was 8.5 days. In univariate analysis, VTE was statistically significantly associated with ovarian and fallopian cancer (P $<$ 0.05), older age (P = 0.001), and blood transfusion (P $<$ 0.001). A multivariate logistic regression model was used to adjust for variables with P $<$ 0.2 in univariate analysis and found that except for age, the other variables continued to have a significant association with VTE. Conclusion: The second week after surgery might be high-risk period of VTE occuring, and ovarian and fallopian tube cancer, abdominal surgery, and blood transfusion might be significant risk factors for developing VTE.

Venous thromboembolism; Gynecologic cancer; Surgery; Pulmonary embolism; Incidence

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