Incidence, Risk Profile and Morphological Pattern of Lower Extremity Venous Thromboembolism After Urological Cancer Surgery

Clément, Christophe; Rossi, P.; Aissi, K.; Barthélémy, Pierre; Guibert, Nicolas; Auquier, Pascal; Ragni, E.; Rossi, D.; Francès, Y.; Bastide, C.

doi:10.1016/j.juro.2011.07.074

Cited by 57 publications

(38 citation statements)

References 29 publications

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“…5,14,15 The overall VTE rate was the highest among patients undergoing radical cystectomy at 5.5% (113 of 2065), whereas the lowest rate of VTE was observed among patients having MIS radical or partial nephrectomy at 0.7% (19 of 2624 and 12 of 1,690, respectively). Although these rates are consistent with previously reported VTE incidence for both radical cystectomy [16][17][18][19] and nephrectomy, 20,21 this study is unique in its ability to demonstrate the large burden of VTE beyond the time of hospital discharge. Remarkably, we found that >80% of VTEs after radical prostatectomy occur in the outpatient setting.…”

Section: Commentsupporting

confidence: 90%

“…Other studies have also failed to demonstrate a significant association between PLND and VTE on multivariate analysis. 19 Still, postdischarge VTE events did occur more frequently in the open radical prostatectomy cohort relative to the MIS radical prostatectomy cohort. The incidence of postdischarge VTE events after open radical prostatectomy was 46 of 3983 (1.2%) compared with an incidence of 101 of 12,865 (0.8%) for MIS radical prostatectomy (P ¼ .028).…”

Section: Commentmentioning

confidence: 84%

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Venous Thromboembolism After Major Urologic Oncology Surgery: A Focus on the Incidence and Timing of Thromboembolic Events After 27,455 Operations

Alberts

Woldu

Weinberg

et al. 2014

Urology

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Section: Commentsupporting

confidence: 90%

Section: Commentmentioning

confidence: 84%

Venous Thromboembolism After Major Urologic Oncology Surgery: A Focus on the Incidence and Timing of Thromboembolic Events After 27,455 Operations

Alberts

Woldu

Weinberg

et al. 2014

Urology

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“…An incidence of 1.8% recorded in this study is comparable with other contemporary series which report VTE rates varied between 0.4 and 5.5% in major urologic oncology surgery [2-5]. We also found that radical cystectomy confers a greater risk of VTE compared to radical cystectomy, again in keeping with published data [6][7][8][9][10][11][12][13]. The probable reason for this is the fact that patients undergoing radical cystectomy have greater risk factors for VTE compared to those undergoing radical prostatectomy.…”

Section: Discussionsupporting

confidence: 91%

Incidence and risk factors of venous thromboembolism after pelvic uro‐oncologic surgery – a single center experience

et al. 2015

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ObjectiveTo determine the incidence and assess risk factors for the development of VTE among patients undergoing major pelvic surgery for prostate and bladder cancer in an Australian tertiary referral center. Patients and MethodsConsecutive patients undergoing major pelvic uro-oncologic surgery, namely radical cystectomy and radical prostatectomy over a five-year period (2009-2013) were identified. Patient variables and types of thromboprophylaxis (pharmacological and/or mechanical) used in this patient cohort were collected for analyses as predictive factors. ResultsThe overall incidence of VTE was 1.8%. Patients undergoing radical cystectomy were more likely to suffer a VTE event compared to patients having radical prostatectomy. In this cohort, the risk factors for VTE include, prolonged operative time of greater than 4 hours (h), lymph node dissection (LND) and patients requiring blood transfusions. ConclusionPatients undergoing major pelvic uro-oncologic surgery have an approximately 1.8% risk of developing VTE. Risk factors identified in this study should be used to guide the use of early and prolonged thromboprophylaxis.

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“…Using the RE model for the primary end point, we identified four studies that were potentially outliers: Clement et al [26], Kauffman et al [27], Maurer et al [28], and Witherington et al [29]. However, in jackknife sensitivity analysis, stepwise removal of these studies only minimally affected the overall pooled event rate (the maximum change in event rate was 0.063%), indicating that the RE pooling was fairly insensitive to these potential outliers (Supplementary Fig.…”

Section: Evidence Synthesismentioning

confidence: 99%

Reporting Bias Leading to Discordant Venous Thromboembolism Rates in the United States Versus Non-US Countries Following Radical Cystectomy: A Systematic Review and Meta-analysis

Fantony

Gopalakrishna

Noord

et al. 2016

European Urology Focus

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Context Postcystectomy bladder cancer (BCa) patients are at high risk for developing venous thromboembolism (VTE). The literature varies widely in the reporting of VTE in this population. Objective To determine the VTE rate in subjects undergoing radical cystectomy (RC) and highlight specific factors affecting this rate. Evidence acquisition This meta-analysis was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database, registration number: CRD42015016776. We queried MEDLINE, the Cochrane Library, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. Search terms captured BCa, RC, and VTE. Per the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, abstracts were reviewed for inclusion/exclusion criteria by two reviewers, and disagreements were resolved by a third reviewer. A search of the gray literature and references of pertinent articles was also performed. The date of our last search was December 15, 2014. For unreported data, authors were contacted. Data were abstracted in duplicate and pooled using a random effects (RE) model. Subgroup analyses and meta-regression were performed to determine risk factors for VTE. Evidence synthesis We identified 2927 publications, of which 223 met inclusion criteria for this review. A total of 1 115 634 surgeries were performed on patient population (80% men) with a total of 51 908 VTEs. The VTE rate estimated by the RE model was 3.7%. Due to significant heterogeneity, subgroup and meta-regression analyses were undertaken. These revealed a higher rate of VTE in US studies at 4.49% compared with “westernized” non-US studies at 3.43% and “nonwesternized” non-US based studies at 2.50%. Other important modifiers included minimally invasive surgery at 5.54% versus open surgery at 3.55%, and age. The case-fatality rate of pulmonary emboli was 44%. Conclusions VTE is common in patients undergoing RC. Reporting of VTE is heterogeneous and the rate varies according to study-level factors, including surgery type and country of origin. Limitations of this study include the preponderance of observational studies in the final analysis and lack of complete reporting of all variables of interest within each study. Patient summary In this review, we determined the venous thromboembolism (VTE) rate in postsurgical bladder cancer patients. VTE events did vary significantly among certain subgroups.

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Incidence, Risk Profile and Morphological Pattern of Lower Extremity Venous Thromboembolism After Urological Cancer Surgery

Cited by 57 publications

References 29 publications

Venous Thromboembolism After Major Urologic Oncology Surgery: A Focus on the Incidence and Timing of Thromboembolic Events After 27,455 Operations

Venous Thromboembolism After Major Urologic Oncology Surgery: A Focus on the Incidence and Timing of Thromboembolic Events After 27,455 Operations

Incidence and risk factors of venous thromboembolism after pelvic uro‐oncologic surgery – a single center experience

Reporting Bias Leading to Discordant Venous Thromboembolism Rates in the United States Versus Non-US Countries Following Radical Cystectomy: A Systematic Review and Meta-analysis

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