OBJECTIVES: Neoadjuvant chemotherapy may be considered for women with epithelial ovarian cancer who have poor

 

Abstract

OBJECTIVES: Neoadjuvant chemotherapy may be considered 

for women with epithelial ovarian cancer who have poor 

performance status or a disease burden not amenable to 

primary cytoreductive surgery. Overlap exists between 

indications for neoadjuvant chemotherapy and known risk 

factors for venous thromboembolism, including impaired 

mobility, increasing age, and advanced malignancy. The 

objective of this study was to determine the rate of 

venous thromboembolism among women receiving 

neoadjuvant chemotherapy for epithelial ovarian cancer.

METHODS: A multi-institutional, observational study of 

patients receiving neoadjuvant chemotherapy for primary 

epithelial ovarian, fallopian tube, or peritoneal 

cancer was conducted. Primary outcome was rate of 

venous thromboembolism during neoadjuvant chemotherapy. 

Secondary outcomes included rates of venous 

thromboembolism at other stages of treatment 

(diagnosis, following interval debulking surgery, 

during adjuvant chemotherapy, or during treatment for 

recurrence) and associations between occurrence of 

venous thromboembolism during neoadjuvant chemotherapy, 

subject characteristics, and interval debulking 

outcomes. Venous thromboembolism was defined as deep 

vein thrombosis in the upper or lower extremities or in 

association with peripherally inserted central 

catheters or ports, pulmonary embolism, or concurrent 

deep vein thrombosis and pulmonary embolism. Both 

symptomatic and asymptomatic venous thromboembolism 

were reported.

RESULTS: A total of 230 patients receiving neoadjuvant 

chemotherapy were included; 63 (27%) patients overall 

experienced a venous thromboembolism. The primary 

outcome of venous thromboembolism during neoadjuvant 

chemotherapy occurred in 16 (7.7%) patients. Of the 

remaining venous thromboembolism events, 22 were at 

diagnosis (9.6%), six post-operatively (3%), five 

during adjuvant chemotherapy (3%), and 14 during 

treatment for recurrence (12%). Patients experiencing a 

venous thromboembolism during neoadjuvant chemotherapy 

had a longer mean time to interval debulking and were 

less likely to undergo optimal cytoreduction (50% vs 

80.2%, p=0.02).

CONCLUSIONS: Patients with advanced ovarian cancer are 

at high risk for venous thromboembolism while receiving 

neoadjuvant chemotherapy. Consideration of 

thromboprophylaxis may be warranted.

PMID: 32054646 [PubMed - as supplied by publisher]

18 February 2020

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Cancer & Heart (Cardio-Oncology, Cardiotoxicity, TEV)

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pubmed: caandvteortroorpul

[Delphi Expert Consensus of the German Thoracic Surgery 

Society on Perioperative Management of Oncological 

Anatomical Lung Resections].

[Delphi Expert Consensus of the German Thoracic Surgery 

Society on Perioperative Management of Oncological 

Anatomical Lung Resections].

Zentralbl Chir. 2020 Feb 17;:

Authors: Koryllos A, Ludwig C, Hecker E, Leschber G