PD-003 - Incidence and risk factors of deep venous thrombosis detected by routine surveillance ultrasonography before surgery in patients with gastric cancer

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Gastric Cancer
Supportive Care
Imaging, Diagnosis and Staging
Surgery and/or Radiotherapy of Cancer
Presenter Y. Tanizawa
Citation Annals of Oncology (2015) 26 (suppl_4): 101-107. 10.1093/annonc/mdv234
Authors Y. Tanizawa, E. Bando, M. Tokunaga, T. Kawamura, R. Makuuchi, K. Nanri, M. Terashima
  • Shizuoka Cancer Center, Shizuoka/JP

Abstract

Introduction

Pulmonary thromboembolism (PTE) is a serious postoperative complication of major surgery, and about 80% of PTE results from deep venous thrombosis (DVT) of the lower extremities. However, the incidence of DVT in patients with gastric cancer before surgery is unknown. We performed routine venous ultrasonography of the lower extremities prior to surgery to detect DVT in gastric cancer patients. The aim of this study was to clarify the incidence and risk factors of DVT of the lower extremities in patients with gastric cancer before surgery.

Methods

From May 2010 to December 2013, 1140 patients who had undergone lower extremity venous ultrasonography as a screening test before surgery for gastric cancer were analyzed. We retrospectively collected the clinicopathological data of patients. In order to select the predictors of DVT before surgery, the following indicators were enumerated: age, sex, performance status (PS), body mass index, tumor stage, history of preoperative chemotherapy, hypertension, chronic heart disease, administration of steroids, lower extremity varicose veins, central venous catheter (CVC), and leg paralysis. The independent risk factors of DVT were determined by multiple logistic regression analysis.

Results

In the 1140 patients, 86 patients (7.5%) were found to have DVT preoperatively, and all patients with DVT were asymptomatic. Univariate analysis demonstrated that the incidence of DVT was significantly higher in women, patients ≥ 80 years old, PS ≥1 (vs. PS: 0), Stage IV (vs. Stages I-III), history of preoperative chemotherapy, and the presence of a CVC. Multivariate logistic regression analysis demonstrated that female sex, age ≥ 80 years, PS ≥ 1, history of preoperative chemotherapy, and the presence of CVC were significantly correlated with DVT before surgery.

Conclusion

Lower extremity venous ultrasonography examination was quite easy to perform, non-invasive, and provided valuable information for thromboprophylaxis. Therefore, we consider ultrasonography useful for the preoperative screening of DVT in patients with gastric cancer, especially female patients aged ≥ 80 years, patients with a history of preoperative chemotherapy, or patients with a CVC.