Symptomatic Venous Thromboembolism in Patients with Malignant Bone and Soft Tissue Tumors: A Prospective Multicenter Cohort Study

• Published in: Annals of surgical oncology Vol. 28; no. 7; pp. 3919 - 3927
• Main Authors: Iwata, Shintaro, Kawai, Akira, Ueda, Takafumi, Ishii, Takeshi
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-07-2021; Springer Nature B.V
• Subjects: Bone surgery; Bone tumors; Cardiovascular disease; Cohort analysis; Coronary artery disease; Embolism; Heart diseases; Ischemia; Medicine; Medicine & Public Health; Oncology; Patients; Platelets; Risk factors; Sarcoma; Surgery; Surgical Oncology; Thromboembolism; Thrombosis; Tumors
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-020-09308-6

Background
A prospective cohort study was conducted to determine the incidence and risk factors of symptomatic venous thromboembolism (sVTE) during the perioperative period in patients with malignant bone and soft tissue tumors.
Methods
Patients with newly diagnosed primary malignant bone and soft tissue tumors for whom definitive surgery was planned were consecutively registered among 27 tertiary hospitals specializing in musculoskeletal oncology. Clinicopathological information on each patient was collected prospectively, and careful follow-up was conducted for 6 months after surgery. The study endpoint was the occurrence of sVTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE).
Results
Eleven of 929 patients developed sVTE, including 8 patients with DVT, 2 with PE, and 1 with both, making the incidence of sVTE 1.18%. The median time until the development of sVTE after tumor resection was 11 days, ranging from − 7 to 95 days. Multiple logistic regression analyses revealed that ischemic heart disease as a comorbidity, maximum tumor diameter exceeding 8 cm, and elevated preoperative platelet count were independent risk factors for sVTE.
Conclusions
The incidence of sVTE in this series of patients with bone and soft tissue sarcomas was 1.18%, which was relatively lower than in previous retrospective studies. We identified the risk factors for sVTE specific to patients with malignant bone and soft tissue tumors, and these included ischemic heart disease, tumor size, and elevation of the preoperative platelet count.