The impact of hereditary thrombophilia on the incidence of postoperative venous thromboembolism in colorectal cancer patients: a prospective cohort study

Ulrych, Jan; Kvasnička, Tomáš; Frýba, Vladimír; Komarc, Martin; Malíková, Ivana; Brzežková, Radka; Kvasnička, Jan; Krška, Z; Bríza, J

doi:10.1007/s10353-018-0534-0

Cited by 2 publications

(9 citation statements)

References 28 publications

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“…We compared surgical versus mixed treatment settings on the basis that cancer surgery itself is a major risk factor for VTE, 64 and since a prior study in colorectal cancer patients reported a higher overall 1-year incidence rate of VTE in surgical patients with thrombophilia mutations compared to without. 47 In our study, we found that studies recruiting only surgical patients had consistent ORs to studies with mixed treatment settings. But, for FVL and Prothrombin FII G20210A mutated patients, the ORs were only statistically significant in the mixed treatment settings, likely due to the small number of surgical studies, which resulted in a wide 95% CI.…”

Section: Discussionsupporting

confidence: 51%

“…Non‐O blood type, FVL, and Prothrombin FII G20210A mutations may be risk factors to consider when assessing for VTE risk and deciding whether to use primary thromboprophylaxis. Although we could not analyze the results by anticoagulation use, in previous studies, a lower incidence of VTE was reported in patients with inherited thrombophilia during prophylactic anticoagulation use 47,62 . Remarkably, the evidence also suggests that the risk of bleeding may not be increased in non‐O blood type and FVL‐mutated cancer patients taking prophylactic anticoagulation 62 .…”

Section: Discussionmentioning

confidence: 71%

“…A subgroup analysis by treatment setting was performed in an attempt to estimate its influence on the association between inherited thrombophilia and VTE risk. We compared surgical versus mixed treatment settings on the basis that cancer surgery itself is a major risk factor for VTE, 64 and since a prior study in colorectal cancer patients reported a higher overall 1‐year incidence rate of VTE in surgical patients with thrombophilia mutations compared to without 47 . In our study, we found that studies recruiting only surgical patients had consistent ORs to studies with mixed treatment settings.…”

Section: Discussionmentioning

confidence: 74%

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Inherited thrombophilia gene mutations and risk of venous thromboembolism in patients with cancer: A systematic review and meta‐analysis

Roy,

Wang,

Lun

et al. 2024

American J Hematol

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In the general population, individuals with an inherited thrombophilia have a higher risk of thrombosis, but the effect of inherited thrombophilia on the risk of cancer‐associated venous thromboembolism (VTE) remains controversial. Our objective was to determine the risk of VTE in cancer patients with inherited thrombophilia. We conducted a systematic review and meta‐analysis of studies reporting on VTE after a cancer diagnosis in adult patients who were tested for inherited thrombophilia. In September 2022, we searched Medline, EMBASE, and Cochrane Central. Two reviewers screened the abstracts/full texts and assessed study quality using the Quality in Prognostic Studies tool. We used Mantel–Haenszel random‐effects models to estimate pooled odds ratios (OR) of VTE and 95% confidence intervals (95%CI). We included 37 and 28 studies in the systematic review and meta‐analysis, respectively. Most studies focused on specific cancer types and hematologic malignancies were rare. The risk of VTE was significantly higher in cancer patients with non‐O (compared with O) blood types (OR: 1.56 [95% CI: 1.28–1.90]), Factor V Leiden, and Prothrombin Factor II G20210A mutations compared with wild types (OR: 2.28 [95% CI: 1.51–3.48] and 2.14 [95% CI: 1.14–4.03], respectively). Additionally, heterozygous and homozygous methylenetetrahydrofolate reductase C677T had ORs of 1.50 (95% CI: 1.00–2.24) and 1.38 (95% CI: 0.87–2.22), respectively. Among those with Plasminogen‐Activator Inhibitor‐1 4G/5G, Vascular Endothelial Growth Factor (VEGF) A C634G, and VEGF C2578A mutations, there was no significant association with VTE. In conclusion, this meta‐analysis provided evidence that non‐O blood types, Factor V Leiden, and Prothrombin Factor II G20210A mutations are important genetic risk factors for VTE in cancer patients.

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 74%

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Inherited thrombophilia gene mutations and risk of venous thromboembolism in patients with cancer: A systematic review and meta‐analysis

Roy,

Wang,

Lun

et al. 2024

American J Hematol

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Section: Resultsmentioning

confidence: 99%

“…These studies specifically examining rates of PE did not report an increased risk in the group with Factor V Leiden positivity, although sample sizes were small. 20,22 Only 1 study that assessed a composite thromboembolic outcome reported no increased risk of transplant-related thrombosis in the Factor V Leiden group, 23 with the remaining 3 reporting a markedly increased risk. [24][25][26] Secondary Outcomes: Mortality, Cerebrovascular Complications, Cardiac Complications, Procedure-Specific Morbidity, and Transplant Outcomes For the outcome of perioperative mortality, only 2 studies reported rates between groups (Table 4), with 2194 control patients and 181 patients with Factor V Leiden compared across the 2 studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

Complications of Factor V Leiden in Adults Undergoing Noncardiac Surgical Procedures: A Systematic Review

Shao

Elias

et al. 2023

Anesthesia &Amp; Analgesia

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Factor V Leiden is the commonest hereditary prothrombotic allele, affecting 1% to 5% of the world’s population. The objective of this study was to characterize the perioperative and postoperative outcomes of patients with Factor V Leiden compared to patients without a diagnosis of hereditary thrombophilia. This was a focused systematic review of studies including adult (>18 years) patients with Factor V Leiden (heterozygous or homozygous) undergoing noncardiac surgery. Included studies were either randomized controlled trials or observational. The primary clinical outcomes of interest were thromboembolic events occurring from the perioperative period up to 1 year postoperatively, defined as deep venous thrombosis, pulmonary embolism, or other clinically significant thrombosis occurring during or after a surgical procedure. Secondary outcomes included cerebrovascular events, cardiac events, death, transplant-related outcomes, and surgery-specific morbidity. Pediatric and obstetrical patients were excluded, as were case reports and case series. Databases searched included MEDLINE and EMBASE from inception until August 2021. Study bias was assessed through the CLARITY (Collaboration of McMaster University researchers) Risk of Bias tools, and heterogeneity through analysis of study design and end points, as well as the I2 statistic with its confidence interval and the Q statistic. A total of 5275 potentially relevant studies were identified, with 115 having full text assessed for eligibility and 32 included in the systematic review. On the whole, the literature suggests that patients with Factor V Leiden have an increased risk of perioperative and postoperative thromboembolic events compared to patients without the diagnosis. Increased risk was also seen in relation to surgery-specific morbidity and transplant-related outcomes, particularly arterial thrombotic events. The literature did not support an increased risk for mortality, cerebrovascular, or cardiac complications. Limitations of the data include predisposition toward bias due in many study designs and small sample sizes across the majority of published studies. Variable outcome definitions and durations of patient follow-up across different surgical procedures resulted in high study heterogeneity precluding the effective use of meta-analysis. Factor V Leiden status may confer additional risk for surgery-related adverse outcomes. Large, adequately powered studies are required to accurately estimate the degree of this risk by zygosity.

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The impact of hereditary thrombophilia on the incidence of postoperative venous thromboembolism in colorectal cancer patients: a prospective cohort study

Cited by 2 publications

References 28 publications

Inherited thrombophilia gene mutations and risk of venous thromboembolism in patients with cancer: A systematic review and meta‐analysis

Inherited thrombophilia gene mutations and risk of venous thromboembolism in patients with cancer: A systematic review and meta‐analysis

Complications of Factor V Leiden in Adults Undergoing Noncardiac Surgical Procedures: A Systematic Review

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