Significance of venous thromboembolism in women with cervical cancer
| Autor: | Aida Moeini, Laurie L. Brunette, Koji Matsuo, Anastasiya Shabalova, Hiroko Machida, Morgan E. Fullerton, Lynda D. Roman |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Uterine Cervical Neoplasms 030204 cardiovascular system & hematology Gastroenterology California Article Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Humans Young adult Risk factor Survival analysis Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Aged 80 and over Gynecology Cervical cancer Univariate analysis business.industry Proportional hazards model Obstetrics and Gynecology Retrospective cohort study Venous Thromboembolism Middle Aged medicine.disease Confidence interval Oncology 030220 oncology & carcinogenesis Female business |
| Zdroj: | Gynecol Oncol |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2016.06.012 |
| Popis: | OBJECTIVE. To characterize risk factors of venous thromboembolism (VTE) and to examine effects of VTE on survival of women with cervical cancer. METHODS. This is a retrospective study examining consecutive stage I–IV cervical cancer cases diagnosed between 2000 and 2014. Cumulative risk of VTE after cervical cancer diagnosis was evaluated by a time-dependent analysis, expressing adjusted-hazard ratio [HR] and 95% confidence interval [CI]. Survival analysis was performed to determine independent risk factors for progression-free survival (PFS) and disease-specific overall survival (OS). RESULTS. VTE was recorded in 98 (12.3%, 95%CI 11.6–22.8) out of 798 cases with 1-, 2-, and 5-year cumulative incidences after cervical cancer diagnosis being 8.4%, 11.3%, and 18.7%, respectively. On multivariable analysis, advanced-stage disease (2-year cumulative risk, distant metastatic disease 44.8% [HR 4.13, 95%CI 1.06–10.7, P = 0.003], and locally-advanced disease 13.4% [HR 2.46, 95%CI 1.17–4.43, P = 0.004]) were independently associated with increased risk of VTE compared to early-stage disease (stage IA1–IB1 4.1%). In addition, low albumin level (HR per unit change, 0.59, 95%CI 0.40–0.85, P = 0.005) and chemotherapy treatment (HR 2.46, 95%CI 1.30–4.66, P = 0.006) remained independent risk factors associated with increased risk of VTE. On univariate analysis, VTE was significantly associated with decreased PFS (5-year rates, 22.3% versus 68.7%, P < 0.001) and OS (5-year rates, 55.1% versus 90.0%, P < 0.001). On multivariable analysis, VTE remained an independent prognostic factor associated with decreased PFS (HR 1.95, 95%CI 1.43–2.67, P < 0.001) and OS (HR 3.54, 95%CI 2.04–6.13, P < 0.001). CONCLUSION. VTE represents aggressive tumor behavior and poor patient condition, and is an independent prognostic factor for decreased survival in women with cervical cancer. |
| Databáze: | OpenAIRE |
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