Correlation between thrombodynamics test levels and the incidence of venous thromboembolic complications in prostate cancer patients undergone radical prostatectomy. Retrospective study

Abstract

Introduction. According to international studies, the frequency of venous thromboembolism (VTE), in cancer patients, is between 5–7 %. The presence of VTE in cancer patients during the oncological treatment increases the risk of lethal outcome. The pelvic cavity, especially in patients with cancer of the prostate gland, represents one of the main thrombogenic localizations. This problem remains actual despite the implementation of modern techniques of VTE prophylaxis and laboratory control of the hemostatic system. Objectives. to assess the correlation between thrombodynamics test levels and the frequency of VTE complications in prostate cancer patients after surgical treatment. Materials and methods. 59 patients undergoing radical prostatectomy with or without lymphadenectomy were included in the study. Preoperative assessment included standard laboratory investigations and an ultrasound examination to exclude deep vein thrombosis in lower extremities. To calculate the risk of VTE, Caprini score was used. Pharmacological prophylaxis of VTE was performed according to the ASCO clinical recommendations with low molecular weight heparin (LMWH), the dose was selected out of the patient weight. In the early postoperative period, standard coagulation tests were performed at 3 control points with the determination of D-dimer and the thrombodynamics test. Ultrasound monitoring of lower extremities was performed on the 3rd day after surgery and the day before discharge. Results. The incidence of VTE in the early postoperative period was found as 5 %. Using the thrombodynamics test we’ve revealed that if the steady-state rate of clot growth rises above 43 μm/min before administration or at the peak of LMWH action in the first 3 days after surgery, the risk of thrombosis increases significantly. Conclusion. The steady-state clot growth rate exceeding 43 μm/min can be used as a criterion for an increased risk of VTE in patients undergone radical prostatectomy.