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Thromboembolic even...
Thromboembolic events in patients undergoing neoadjuvant chemotherapy and radical cystectomy for muscle-invasive bladder cancer : a study of renal impairment in relation to potential thromboprophylaxis
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- Rydell, Harriet (author)
- Umeå universitet,Urologi och andrologi
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- Ericson, Anna (author)
- Umeå universitet,Urologi och andrologi
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- Eriksson, Victoria (author)
- Umeå universitet,Urologi och andrologi
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- Johansson, Markus (author)
- Umeå universitet,Urologi och andrologi,Department of Surgery, Urology Section, Sundsvall-Härnösand Hospital, Sundsvall, Sweden
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- Svensson, Johan, 1978- (author)
- Umeå universitet,Statistik
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- Banday, Viqar Showkat (author)
- Umeå universitet,Urologi och andrologi
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- Sherif, Amir (author)
- Umeå universitet,Urologi och andrologi
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(creator_code:org_t)
- 2022-11-27
- 2022
- English.
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In: Journal of Personalized Medicine. - : MDPI. - 2075-4426. ; 12:12
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https://doi.org/10.3...
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https://umu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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Abstract
Subject headings
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- Recent studies on patients with muscle-invasive bladder cancer (MIBC) undergoing neoadjuvant chemotherapy (NAC) have shown an association between NAC and thromboembolic events (TEE) prior to radical cystectomy (RC). Recent studies suggest that central venous access catheters (CVAs) may induce TEEs, and low-molecular-weight heparin (LMWH) has been mentioned as possible prophylaxis. However, other studies have shown a high incidence of decreased renal function in these patients. The purpose of this study was to determine the portion of MIBC patients with NAC-induced TEEs who had decreased preoperative renal function for whom LMWH potentially would not be beneficial as prophylaxis. We identified 459 cystectomized MIBC patients from two Swedish medical centers from 2009 to 2021. The inclusion criterion of cT2-T4aN0M0 resulted in 220 eligible patients, who were further divided into NAC-administered (n = 187) and NAC-eligible (n = 33), the tentative control group. Values of renal function before, during, and after each NAC cycle were retrospectively collected from individual medical records. Amongst the NAC-administered patients with TEE (n = 29), 41% (95% CI 23.5-61.1%) of patients had decreased renal function. Thus, a substantial portion of NAC-administered patients who developed TEEs had reduced renal function and would have been less likely to have benefited from renal clearance-dependent LMWH prophylaxis.
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
- low-molecular-weight heparin
- neoadjuvant therapy
- thromboembolism
- urinary bladder neoplasms
Publication and Content Type
- ref (subject category)
- art (subject category)
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