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Observational Study
. 2017 Jun-Jul;95(6):328-334.
doi: 10.1016/j.ciresp.2017.05.006. Epub 2017 Jun 20.

Form of presentation, natural history and course of postoperative venous thromboembolism in patients operated on for pelvic and abdominal cancer. Analysis of the RIETE registry

[Article in English, Spanish]
Ana Belén Bustos Merlo  1 , Juan Ignacio Arcelus Martínez  2 , Jesús Damián Turiño Luque  3 , Beatriz Valero  4 , Aurora Villalobos  5 , Miguel Ángel Aibar  6 , Manuel Monreal Bosch  7 ; miembros del grupo RIETE
Affiliations
Observational Study

Form of presentation, natural history and course of postoperative venous thromboembolism in patients operated on for pelvic and abdominal cancer. Analysis of the RIETE registry

[Article in English, Spanish]
Ana Belén Bustos Merlo et al. Cir Esp. 2017 Jun-Jul.

Abstract

Introduction: Venous thromboembolism (VTE) represents a serious complication after oncologic surgery. Recent studies have shown that the risk of VTE persists several weeks after surgery. This study assesses the form of presentation and time course of VTE after abdominal and pelvic cancer surgery.

Methods: Prospective, multicenter, observational study that analyzes data from an international registry (RIETE) that includes consecutive patients with symptomatic VTE. Our study assesses the form and time of presentation of postoperative VTE, as well as main outcomes, in patients operated for abdominopelvic cancer 8 weeks prior to VTE diagnosis. Variables related to the presentation of VTE after hospital discharge are identified.

Results: Out of the 766 analyzed patients with VTE, 395 (52%) presented pulmonary embolism (PE). Most VTE cases (84%) were detected after the first postoperative week, and 38% after one month. Among patients with VTE in the first postoperative week, 70% presented PE. VTE presented after hospital discharge in 54% of cases. Colorectal, urologic, and gynecologic tumors, the use of radiotherapy, and blood hemoglobin levels were independently associated with VTE diagnosis after hospital discharge. Complications (thrombosis recurrence, bleeding, and death) occurred in 34% of patients with VTE detected before hospital discharge, compared to 24% in VTE after hospital discharge (P<0.01).

Conclusions: VTE occurs after hospital discharge in most patients, particularly in those operated for colorectal, urologic, and gynecologic cancer. Pulmonary embolism is more frequent in patients who develop early VTE, who also have worse prognosis.

Keywords: Antithrombotic prophylaxis; Cirugía oncológica; Deep vein thrombosis; Embolismo pulmonar; Historia natural; Oncologic surgery; Profilaxis antitrombótica; Pulmonary embolism; Time course; Trombosis venosa profunda.

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