Prospective Study of Venous Thromboembolism in Patients With Head and Neck Cancer After Surgery

Abstract

This interim analysis of the first prospective study of the incidence of VTE in patients with head and neck cancer showed a VTE rate slightly higher than previously estimated in retrospective studies. There have been no unexpected serious adverse events and no rationale for early termination of the study.

Systematic review and meta‐analysis of venous thromboembolism in otolaryngology–head and neck surgery

“…Seven series did not specifically report the incidence of DVT, and 6 series did not specifically report PE, although the information for the incidence of VTE was available for all articles. It is important to mention that in the study by Clayburgh et al with the highest incidence of DVT (7.0%), all patients underwent ultrasonography on postoperative day 2, a potential source of bias in the detection rate as many of these may not have been clinically evident or relevant. In this study, if only the symptomatic patients were to be included, the incidence of DVT would decrease to 3.0%.…”

“…The search did not identify any randomized trials regardless of sample size on this topic in OHNS. The only prospective study (LOE 1b) was conducted by Clayburgh et al in 2013, however, this was the study with the smallest number of patients ( n = 100). According to the Oxford Center for Evidence‐Based Medicine 2011 LOE, all other studies were either retrospective cohort studies (LOE 2b) or outcomes research studies using databases (LOE 2c).…”

“…Before reviewing any articles, a number of techniques were used to ensure that all the relevant references were included in our search algorithm and results. Citations were cross‐checked (snowballing) from key publications . Citations from existing reviews were assessed, the “related articles” to key publications in PubMed were reviewed, forward citations were used, and one expert in the field (S.P.…”

Use of thrombin‐based haemostatic matrix in head and neck reconstructions: a potential risk factor for pulmonary embolism

“…However, despite these potential risk factors, patients undergoing oncologic head and neck reconstructions have similar incidence of PE, ranging from 0% to 1.0% to patients undergoing general surgery procedures, ranging from 0.2% to 0.9% . The low reported incidence may be due to the inclusion of patients who underwent less complex reconstructions utilizing local and pedicled flaps . Although the incidence of symptomatic PE measured in our institute only included patients who have undergone free flap reconstructions, 6.9% incidence is nevertheless an outlier when compared to the current literature and the baseline incidence in our institution from 2007 to 2013 (1.5%).…”

“…Patients undergoing oncologic head and neck reconstructions, compared with non‐head and neck reconstruction, were older, underwent longer anaesthesia times, spent more days in the hospital and were more likely to need free flaps . However, despite these potential risk factors, patients undergoing oncologic head and neck reconstructions have similar incidence of PE, ranging from 0% to 1.0% to patients undergoing general surgery procedures, ranging from 0.2% to 0.9% . The low reported incidence may be due to the inclusion of patients who underwent less complex reconstructions utilizing local and pedicled flaps .…”