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10 - Thrombosis prophylaxis and risk factors for thrombosis in gynecologic oncology

Published online by Cambridge University Press:  01 February 2010

By
Georg-Friedrich von Tempelhoff M.D., F.A.C.T.H.
Edited by
Rodger L. Bick ,
Eugene P. Frenkel ,
William F. Baker  and
Ravi Sarode
Georg-Friedrich von Tempelhoff M.D., F.A.C.T.H.
Affiliation:
Specialist in Gynecology and Obstetrics, Department of Obstetrics and Gynecology GP Rüsselsheim, Teaching Hospital of the Johannes Gutenberg-University Main 2, Rüsselsheim, Germany
Rodger L. Bick
Affiliation:
University of Texas Southwestern Medical Center, Dallas
Eugene P. Frenkel
Affiliation:
University of Texas Southwestern Medical Center, Dallas
William F. Baker
Affiliation:
University of California, Los Angeles
Ravi Sarode
Affiliation:
University of Texas Southwestern Medical Center, Dallas
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Summary

Introduction

Malignancy is an independent risk factor for the development of venous thrombosis (VT) and the latter belongs to the most common and life-threatening complications in patients with gynecological malignancy. Most thrombotic complications are recognized while patients undergo cancer treatment. Breast cancer patients under observation were found to experience VT in 0 to 3% compared to an overall incidence per year of about 0.3% in women. Incidence of VT does not exceed 1.5% following surgery for breast cancer, irrespectively of whether patients had radical or breast conserving surgery. VT occurs in about 1 out of 5 patients after Wertheim – Meigs surgery for cervical and endometrial cancer despite receiving thrombosis prophylaxis and every 4th patient with ovarian malignancy is confronted with VT during the time of primary treatment (surgery and first-line chemotherapy). According to a statement by the Subcommittee Thrombosis and Haemostasis in Malignancy of the International Society on Thrombosis and Haemostasis (ISTH) a 5% incidence of VT can be expected in the course of adjuvant chemotherapy for breast cancer, which is of concern since most breast cancer patients will receive adjuvant chemotherapy. According to the American Cancer Society (ACS) estimates for 2004, 217,000 new cases of invasive breast cancer, 50,840 cases of uterine cancer and 25,580 cases of ovarian cancer will be diagnosed in the United States. Thus some 13,000 patients (6%) with breast cancer, 10,000 patients with uterine malignancy, and 6,300 women with ovarian cancer will develop thrombosis within the first year after diagnosis of cancer.

Type
Chapter
Information
Hematological Complications in Obstetrics, Pregnancy, and Gynecology , pp. 310 - 340
Publisher: Cambridge University Press
Print publication year: 2006

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