Abstract 130P
Background
Surgery for sarcomas carries a risk of pulmonary embolism (PE), a potentially fatal complication. Timely identification of preoperative deep vein thrombosis (VTE) is crucial for safety. Limited research has focused on preoperative thrombotic events in sarcoma surgeries. This study aims to identify VTE risk factors in sarcoma patients and evaluate a screening method using preoperative coagulofibrinolytic markers, such as plasma D-dimer (DD) and fibrinogen degradation products (FDP) levels.
Methods
A retrospective review of 384 sarcoma patients (282 soft tissue, 102 bone) undergoing surgery was conducted. Multivariate analysis was performed on factors including gender, age, BMI, tumor site, diagnosis, preoperative adjuvant therapy, paralysis, diabetes, heart disease, and smoking history. Preoperative plasma DD levels were compared with FDP in 145 patients undergoing VTE testing via echocardiography or computed tomography scans. Interventions varied based on VTE status, including anticoagulants for VTE-positive patients and elastic stockings with foot pumps for VTE-negative patients.
Results
Preoperative VTE was detected in 4.7% (18 cases), with no postoperative symptomatic PEs. Risk factors included history of thrombosis, preoperative infection, lower limb tumors, and age (>65 years). ROC analysis for DD and FDP revealed AUC values of 0.77 and 0.68. DD cut-off was 4.35 μg/mL (sensitivity 77.8%, specificity 81.9%), and FDP cut-off was 8.60 μg/mL (sensitivity 77.8%, specificity 63.0%). A noteworthy DD cut-off of 1.0 μg/mL showed 100% sensitivity for VTE screening.
Conclusions
This study suggested the independent risk factors for preoperative VTE in sarcoma patients, emphasizing the significance of the history of thrombosis, age, lower limb tumors, and preoperative infections. DD superiority over FDP in VTE screening is evident, advocating a recommended 1.0 μg/mL cut-off for sarcoma preoperative screening. Addressing these risk factors is vital for successful preventive measures and reducing PE incidence in sarcoma surgeries.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.