Fumihiko Kato1, Hiroya Takeuchi2, Satoru Matsuda1, Hirofumi Kawakubo1, Tai Omori1, Yuko Kitagawa1. 1. Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. 2. Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. htakeuchi@a6.keio.jp.
Abstract
PURPOSE: During the treatment of esophageal cancer with curative intent, patients sometimes experience deep vein thrombosis, pulmonary embolism or a central venous catheter-associated thrombus. In this study, we retrospectively reviewed our new-onset esophageal cancer patients and determined the incidence of venous thromboembolism (VTE), the location of the thrombus and the risk factors for VTE. METHODS: One hundred and fifty-three patients undergoing treatment with curative intent were reviewed as candidates. The existence of VTE was assessed from the neck to the pelvis with computed tomography at the initial visit, after neo-adjuvant chemotherapy and postoperatively. RESULTS: Twenty-one VTE events (13.7%) were observed, 16 of which (76.2%) were suggested to be associated with central venous catheterization. When both the pre-therapeutic plasma fibrinogen and C-reactive protein levels were high (≥350 mg/dL and ≥0.2 µg/mL, respectively), the risk of preoperative VTE and overall VTE were significantly higher than normal (p = 0.040, and p = 0.030, respectively). Adenocarcinoma histology and neck lymph node dissection were the independent risk factors that significantly increased the overall risk of VTE (p = 0.015, and p = 0.017, respectively). CONCLUSIONS: This study revealed that the pre-therapeutic plasma fibrinogen level, C-reactive protein level, adenocarcinoma histology and neck lymph node dissection are the risk factors for venous thromboembolism in patients with esophageal cancer undergoing treatment with curative intent.
PURPOSE: During the treatment of esophageal cancer with curative intent, patients sometimes experience deep vein thrombosis, pulmonary embolism or a central venous catheter-associated thrombus. In this study, we retrospectively reviewed our new-onset esophageal cancerpatients and determined the incidence of venous thromboembolism (VTE), the location of the thrombus and the risk factors for VTE. METHODS: One hundred and fifty-three patients undergoing treatment with curative intent were reviewed as candidates. The existence of VTE was assessed from the neck to the pelvis with computed tomography at the initial visit, after neo-adjuvant chemotherapy and postoperatively. RESULTS: Twenty-one VTE events (13.7%) were observed, 16 of which (76.2%) were suggested to be associated with central venous catheterization. When both the pre-therapeutic plasma fibrinogen and C-reactive protein levels were high (≥350 mg/dL and ≥0.2 µg/mL, respectively), the risk of preoperative VTE and overall VTE were significantly higher than normal (p = 0.040, and p = 0.030, respectively). Adenocarcinoma histology and neck lymph node dissection were the independent risk factors that significantly increased the overall risk of VTE (p = 0.015, and p = 0.017, respectively). CONCLUSIONS: This study revealed that the pre-therapeutic plasma fibrinogen level, C-reactive protein level, adenocarcinoma histology and neck lymph node dissection are the risk factors for venous thromboembolism in patients with esophageal cancer undergoing treatment with curative intent.
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