Minimizing tumor burden by extensive cytoreductive surgery decreases postoperative venous thromboembolism in ovarian clear cell carcinoma

Abstract

A venous thromboembolism (VTE) is prevalent in patients with ovarian clear cell carcinoma (OCCC). Tumor burden and extensive cytoreductive surgery are well-known risk factor for a VTE. The purpose of this study was to define the incidence of VTE after extensive cytoreductive surgery and to clarify the relationship between VTE and extensive cytoreductive surgery in patients with OCCC. We reviewed the medical charts of 43 patients treated at the National Cancer Center between June 2000 and July 2007. Most surgical procedures were performed with peri-operative thrmoboprophylaxis. Eight (18.6%) patients had deep vein thromboses and three of eight patients had a pulmonary thromboembolism. A VTE was identified at initial presentation in four patients, at recurrence in one patient, and during 3rd line chemotherapy in three patients when the patients had a bulky tumor burden. The rate of optimal debulking surgery was 95.3% and no patient had a VTE during the postoperative recovery period and adjuvant chemotherapy. A VTE was associated with disease status only (P=0.042). Minimizing residual tumor by extensive cytoreductive surgery with peri-operative thromboprophylaxis may decrease the incidence of a postoperative VTE in patients with OCCC. Larger, prospective studies are needed to confirm these preliminary findings.