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The increased risk ...
The increased risk for thromboembolism pre-cystectomy in patients undergoing neoadjuvant chemotherapy for muscle-invasive urinary bladder cancer is mainly due to central venous access : a multicenter evaluation
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- Ottosson, Kristoffer (author)
- Umeå universitet,Urologi och andrologi,Umea Univ, Sweden
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- Pelander, Sofia (author)
- Linköpings universitet,Institutionen för klinisk och experimentell medicin,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland
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- Johansson, Markus (author)
- Umeå universitet,Urologi och andrologi,Department of Urology, Sundsvall Hospital, Sundsvall, Sweden,Umea Univ, Sweden; Sundsvall Hosp, Sweden
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- Huge, Ylva (author)
- Linköpings universitet,Institutionen för klinisk och experimentell medicin,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland
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- Abdul-Sattar Aljabery, Firas (author)
- Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland
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- Sherif, Amir (author)
- Umeå universitet,Urologi och andrologi,Umea Univ, Sweden
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(creator_code:org_t)
- 2019-11-19
- 2020
- English.
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In: International Urology and Nephrology. - : Springer. - 0301-1623 .- 1573-2584. ; 52:4, s. 661-669
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Abstract
Subject headings
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- Purpose: To investigate if patients receiving neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer (MIBC) had an increased risk of thromboembolic events (TEE) and to evaluate when these events occur on a timeline starting from 6 months pre-cystectomy, during NAC-administration and 60 months post-cystectomy.Methods: Two hundred and fifty five patients undergoing radical cystectomy during 2009–2014 at three Swedish cystectomy centers (Umeå, Linköping and Sundsvall) were in-detail reviewed retrospectively, using individual medical records. One hundred and twenty nine patients were ineligible for analysis. NAC patients (n = 67) were compared to NAC-naïve NAC-eligible patients (n = 59). The occurrence of TEE was divided into different periods pre-cystectomy and post-cystectomy. Statistical analyses included Chi-squared and logistical regression tests.Results: Significant associations were found between receiving NAC and acquiring a TEE during NAC therapy pre-cystectomy. All but one pre-cystectomy event was venous and all but one of the patients received NAC. 31% (14/45) of TEEs occurred pre-cystectomy. The incidence of TEEs pre-cystectomy in NAC-naive NAC-eligible patients was only 10% (2/20), whereas the incidence of TEEs in NAC patients occurred pre-cystectomy in 48% (12/25) and 11/12 incidents were detected during NAC therapy—this including 7/11 (64%) incidents affecting veins in anatomical conjunction with the placement of central venous access for chemotherapy administration.Conclusions: There is a significantly increased risk for TEE pre-cystectomy during chemotherapy administration in MIBC patients receiving NAC, compared to the risk in NAC-naïve NAC-eligible MIBC patients. In 64% of the pre-RC TEEs in NAC patients, there was a clinical connection to placement of central venous access.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Keyword
- Complications
- Cystectomy
- Neoadjuvant therapy
- Thromboembolism
- Urinary bladder neoplasms
Publication and Content Type
- ref (subject category)
- art (subject category)
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