Symptomatic Venous Thromboembolism in Patients with Malignant Bone and Soft Tissue Tumors: A Prospective Multicenter Cohort Study
Symptomatic Venous Thromboembolism in Patients with Malignant Bone and Soft Tissue Tumors: A Prospective Multicenter Cohort Study
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DOI：
10.1245/s10434-020-09308-6
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发表时间：
2020-11-09
影响因子：
3.7
通讯作者：
Sawada, Ryoko
中科院分区：
文献类型：
--
作者：
Iwata, Shintaro;Kawai, Akira;Sawada, Ryoko
背景：进行了一项前瞻性队列研究，以确定恶性骨和软组织肿瘤患者围手术期症状性静脉血栓栓塞（sVTE）的发生率和危险因素。方法对27家三级医院肌肉骨骼肿瘤科初诊的原发性恶性骨与软组织肿瘤患者进行连续登记，确定手术治疗方案。前瞻性收集每例患者的临床病理信息，并在术后6个月进行仔细随访。研究终点为sVTE的发生，包括深静脉血栓形成（DVT）和肺栓塞（PE）。结果929例患者中11例发生sVTE，其中DVT 8例，PE 2例，DVT和PE并存1例，sVTE发生率为1.18%。肿瘤切除后发生sVTE的中位时间为11天，范围为-7至95天。多元Logistic回归分析显示，缺血性心脏病作为合并症，最大肿瘤直径超过8 cm，术前血小板计数升高是sVTE的独立危险因素。结论本组骨与软组织肉瘤患者sVTE发生率为1.18%，较以往回顾性研究相对降低。我们确定了恶性骨和软组织肿瘤患者sVTE的危险因素，包括缺血性心脏病、肿瘤大小和术前血小板计数升高。
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.