Prospective Study on the Incidence of Postoperative Venous Thromboembolism in Korean Patients with Colorectal Cancer.
- Author:
Eunyoung LEE
1
;
Sung Bum KANG
;
Sang Il CHOI
;
Eun Ju CHUN
;
Min Jeong KIM
;
Duck Woo KIM
;
Heung Kwon OH
;
Myong Hoon IHN
;
Jin Won KIM
;
Soo Mee BANG
;
Jeong Ok LEE
;
Yu Jung KIM
;
Jee Hyun KIM
;
Jong Seok LEE
;
Keun Wook LEE
Author Information
- Publication Type:Original Article
- Keywords: Asia; Colorectal neoplasms; Incidence; Colorectal surgery; Venous thromboembolism
- MeSH: Asia; Asian Continental Ancestry Group; Cohort Studies; Colorectal Neoplasms*; Colorectal Surgery; Comorbidity; Humans; Incidence*; Leukocyte Count; Prospective Studies*; Risk Factors; Thrombosis; Ultrasonography, Doppler; Veins; Venous Thromboembolism*
- From:Cancer Research and Treatment 2016;48(3):978-989
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Pharmacologic thromboprophylaxis is routinely recommended for Western cancer patients undergoing major surgery for prevention of venous thromboembolism (VTE). However, it is uncertainwhetherroutine administration of pharmacologic thromboprophylaxis is necessary in all Asian surgical cancer patients. This prospective study was conducted to examine the incidence of and risk factors for postoperative VTE in Korean colorectal cancer (CRC) patients undergoing major abdominal surgery. MATERIALS AND METHODS: This study comprised two cohorts, and none of patients received perioperative pharmacologic thromboprophylaxis. In cohort A (n=400), patients were routinely screened for VTE using lower-extremity Doppler ultrasonography (DUS) on postoperative days 5-14. In cohort B (n=148), routine DUS was not performed, and imaging was only performed when there were symptoms or signs that were suspicious for VTE. The primary endpoint was the VTE incidence at 4 weeks postoperatively in cohort A. RESULTS: The postoperative incidence of VTE was 3.0% (n=12) in cohort A. Among the 12 patients, eight had distal calf vein thromboses and one had symptomatic thrombosis. Age ≥ 70 years (odds ratio [OR], 5.61), ≥ 2 comorbidities (OR, 13.42), and white blood cell counts of > 10,000/μL (OR, 17.43) were independent risk factors for postoperative VTE (p < 0.05). In cohort B, there was one case of VTE (0.7%). CONCLUSION: The postoperative incidence of VTE, which included asymptomatic cases, was 3.0% in Korean CRC patients who did not receive pharmacologic thromboprophylaxis. Perioperative pharmacologic thromboprophylaxis should be administered to Asian CRC patients on a risk-stratified basis.
