Abstract
Introduction Venous thromboses and their consequences are among the main causes of death in patients
with tumour diseases. The objective of this study is the analysis of risk factors
and the evaluation of the applicability of two risk scores in a purely gynaecological
oncology patient collective. The identification of patients at high risk for the occurrence
of venous thromboses could enable the implementation of targeted medication-based
thrombosis prophylaxis which has a significant benefit and, simultaneously, a low
risk.
Materials and Methods A retrospective case-control study on 152 patients who were undergoing oncological
treatment in the Department of Gynaecology of the Mainz University Medical Centre
between 2006 and 2013 investigated the data from 104 patients with breast, 26 with
ovarian and 22 with cervical cancer. A control was assigned to 76 subjects in the
case group who suffered a venous thrombosis during chemotherapy and this control coincided
in the points of tumour location, age, lymph node involvement, metastasis and time
of initial diagnosis. The group differences were analysed using the χ2 test, t test, Mann-Whitney-U test and a logistic regression analysis.
Results There were clear group differences in the lack of inpatient thrombosis prophylaxis
(p = 0.014), elevated leukocyte counts (p = 0.018) prior to the start of chemotherapy
and port systems (p = 0.032). Surgical interventions were confirmed to be an independent
risk factor (p ≤ 0.001). The Khorana and Protecht scores did not emerge from the analysis
as independent predictors for a thrombosis. More patients died in the case group than
in the control group (p = 0.028; OR: 8.1; CI: 1.254 – 52.162).
Conclusion In this patient collective, surgeries represent an independent risk factor for venous
thromboses. In addition, a correlation was seen between inpatient thrombosis prophylaxis,
leukocytosis as well as port systems and an increased risk of thrombosis. Neither
the Khorana nor the Protecht score were independent risk factors for venous thromboses.
Significantly more thrombosis patients died during the observation period.
Key words
thrombosis - gynaecological cancer - chemotherapy - operations
