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H. Li
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P3.16 - Surgery (ID 732)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.16-030 - Venous Thromboembolism After Lung Cancer Surgery and Its Risk Factors: A Single Center, Retrospective, Cohort Study from China (ID 9247)
09:30 - 09:30 | Author(s): H. Li
- Abstract
Background:
The high Venous Thromboembolism (VTE) incidence has been perceived in post-surgery lung cancer patients. However, there is lack of effective data from such area in China. To evaluate the incidence of VTE and define risk factors for primary lung cancer, we conducted a retrospective single center cohort study.
Method:
252 patients were enrolled in this study, included 131 primary lung cancer patients and 121 benign lung disease patients after lung surgery from July 2016 to March 2017. The Color Doppler Ultrasonography was performed before and after operation for VTE confirmation. Patients experienced new postoperative VTE, unexplained dyspnea, hemoptysis, chest pain, highly suspected PE and other symptoms, further CTPA examination was required. The VTE incidence was evaluated after discharge. Caprini RAM was performed; relative outcomes had been recorded for all patients. Caprini scores 0 to 4 were defined as low-risk, 5 to 8 as moderate-risk and over 9 as high-risk. Single factor analysis was constructed to define risk factors associated with VTE.
Result:
The overall VTE incidence was 12.3% (31 of 252). The VTE incidence after primary lung cancer surgery was 16.0% (21 of 131), much higher than the VTE incidence of benign lung diseases 8.3% (10 of 121), but did not reach statistical significance (P=0.061). Among 21 VTE lung cancer patients, 4.8% was SVT (1), 81.0% DVT (17), and 14.3% was DVT+PE (3); 15 patients (71.4%) have manifested intramuscular venous thrombosis. Those 21 VTE patients possessed high Caprini scores, which was significantly higher than non-VTE patients in benign lung disease group (Score: 7 versus 4, P﹤0.001). Postoperative VTE incidence was correlated with increasing Caprini scores. The VTE incidence in the low, moderate, and high-risk groups was 0%, 13.4% and 35.3% respectively. The high-risk patients group had significant higher incidence than the low and moderate groups (P=0.049). In lung cancer patients, pre-operative D-Dimer concentration from VTE patients was 2 times higher than non-VTE patients (0.42 versus 0.21, P=0.015) and 1.7 times higher than patients postoperatively at day 3 (1.24 versus 0.71, P=0.008). FDP concentration in VTE patients postoperatively at day 3 was 1.8 times higher than non-VTE patients (6.40 versus 3.60, P﹤0.001).
Conclusion:
The overall incidence of VTE after primary lung cancer surgery was 16.0%. High-risk patients had an incidence of 35.3%. High Caprini scores suggest extended chemoprophylaxis for patients after discharge. Pre-operative high D-Dimer, POD3 high D-Dimer and POD3 high FDP concentration indicate high VTE risk.
