IMR Press / EJGO / Volume 40 / Issue 3 / DOI: 10.12892/ejgo4721.2019
Open Access Original Research
Recurrence of venous thromboembolism in patients with gynaecological malignancies: incidence, risk factors, and impact on survival
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1 Department of Gynaecology Oncology, St. James's Hospital, Dublin 8, Ireland
2 Trinity College Department of Obstetrics and Gynaecology, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland
Eur. J. Gynaecol. Oncol. 2019, 40(3), 413–419;
Published: 10 June 2019

Purpose: The purpose of this study was to define the incidence, risk factors, and impact on survival of venous thromboembolism (VTE) recurrence in patients with genital tract malignancy. Materials and Methods: This was a retrospective cohort study of patients with gynaecological malignancies treated in the Tertiary Gynaecological Cancer Centre Hospital between 2006 and 2017. Patients with cancer-related VTE were identified. Demographic data, histology, stage, surgery, chemotherapy, co-morbidities, and timing of primary and recurrent VTE episodes were recorded. Results: One hundred and twenty-four gynaecological malignancies were diagnosed with cancer associated VTE. The incidence of recurrent VTE was 22% (n = 27). Patients were at highest risk of recurrent VTE if their first VTE had occurred before commencement of primary cancer treatment (OR 2.2, 95% CI 1.1-4.2 p = 0.018). Seventeen (63%) patients were on a therapeutic dose of low molecular weight heparin at the time of recurrent VTE. Patients with recurrent VTE had significantly higher monocyte (p = 0.03) and eosinophil count (p ≤ 0.01) compared to the non-recurrent VTE group. There was no difference in progression-free and overall survival between patients who suffered a single VTE and those who had recurrent VTE. Conclusions: Patients with gynaecological malignancies treated for VTE remain at high risk of recurrent VTE despite standard anticoagulant treatment.

Venous thromboembolism
VTE recurrence
Gynaecological malignancies
Gynaecological cancer
Cancer associated venous thromboembolism
Figure 1.
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