Risk Factors for Venous Thromboembolism in Endometrial Cancer

Abstract

Background: Venous thromboembolism (VTE) in malignancy is associated with poor outcomes. We conducted a retrospective review of VTE in patients with endometrial cancer to characterize the VTE incidence, identify factors that contribute to VTE risk, and compare survival outcomes in patients with and without VTE. Methods: A retrospective chart review identified 422 eligible patients who underwent surgery for endometrial cancer (1 January 2014 to 31 July 2016). The primary outcome was VTE. Binary logistic regression identified risk factors for VTE; significant risk factors were included in a multivariate analysis. Kaplan–Meier estimates are reported, and log rank tests were used to compare the Kaplan–Meier curves. Risk-adjusted estimates for overall survival based on VTE were determined using a multivariate Cox proportional hazards model. Results: The incidence of VTE was 6.16% overall and 0.7% within 60 days postoperatively. Non-endometrioid histology, stages 3 and 4 disease, laparotomy, and age (p < 0.1) were identified as factors associated with VTE and were included in a multivariate analysis. The overall death rate in patients with VTE was 42% (9% without VTE): hazard ratio, 5.63; 95% confidence interval, 2.86 to 11.08; p < 0.0001. Adjusting for age, stage of disease, and histology, risk of death remained significant for patients with a VTE: hazard ratio, 2.20; 95% confidence interval, 1.09 to 4.42; p = 0.0271. Conclusions: A method to identify patients with endometrial cancer who are at high risk for VTE is important, given the implications of VTE for patient outcomes and the frequency of endometrial cancer diagnoses. Factors identified in our study might assist in the recognition of such patients.