[Incidence and impact of venous thrombosis in the diagnosis and therapeutic management of ovarian cancer]

Gynecol Obstet Fertil Senol. 2020 Jun;48(6):506-513. doi: 10.1016/j.gofs.2020.03.007. Epub 2020 Mar 12.
[Article in French]

Abstract

Objective: Ovarian cancer is a risk factor for venous thromboembolism (VTE), which worsens overall survival. The main objective of our study was to calculate the incidence of VTE in our population. We analyzed VTE impact on diagnosis and management of ovarian cancer.

Methods: We conducted a retrospective, monocentric study in ovarian, fallopian tube and primary peritoneal cancer patients, divided into 2 groups (« Presence of VTE » and « Absence of VTE »). A univariate and multivariate analysis of factors associated with VTE was performed, and we compared delays of management in both groups.

Results: Among 157 patients included in the study, 22.9% presented a VTE, and 52.8% were asymptomatic. The VTE was diagnosed prior to any treatment in 61.1% of patients and revealed the ovarian cancer in 27.8% of cases. In multivariate analysis, tumor size (OR=1.1, 95% CI: 1-2.21, P=0.012), malnutrition (OR=3.79, 95% CI: 1.16-12,4, P=0.028) and Ddimer level above 1.5μg/mL (OR=13.8, 95% CI 1.2-152.8, P=0.02) were significantly associated with VTE. No significant difference was found between the two groups in diagnostic or therapeutic strategy, as well as in delays of management.

Conclusion: We report a high incidence of VTE in ovarian cancer, including a lot of asymptomatic events. An early diagnosis with clinical examination and Ddimer level could improve its management and its prognosis.

Keywords: Cancer ovarien; Embolie pulmonaire; Impact thérapeutique; Incidence; Ovarian cancer; Pulmonary embolism; Therapeutic impact; Thrombose veineuse; Venous thrombosis.

MeSH terms

  • Aged
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis
  • Humans
  • Malnutrition / complications
  • Middle Aged
  • Odds Ratio
  • Ovarian Neoplasms / complications*
  • Ovarian Neoplasms / diagnosis
  • Ovarian Neoplasms / therapy
  • Retrospective Studies
  • Risk Factors
  • Venous Thrombosis / complications
  • Venous Thrombosis / diagnosis
  • Venous Thrombosis / epidemiology*

Substances

  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D