PD27-09 INCIDENCE AND SIGNIFICANCE OF THROMBO-EMBOLIC EVENTS IN BLADDER UROTHELIAL CARCINOMA PATIENTS UNDERGOING NEO-ADJUVANT CHEMOTHERAPY AND RADICAL CYSTECTOMY: RESULTS FROM MULTI-CENTRE NORTH-AMERICAN AND EUROPEAN CONTEMPORARY DATA

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive II1 Apr 2016PD27-09 INCIDENCE AND SIGNIFICANCE OF THROMBO-EMBOLIC EVENTS IN BLADDER UROTHELIAL CARCINOMA PATIENTS UNDERGOING NEO-ADJUVANT CHEMOTHERAPY AND RADICAL CYSTECTOMY: RESULTS FROM MULTI-CENTRE NORTH-AMERICAN AND EUROPEAN CONTEMPORARY DATA Wilhelmina Duivenvoorden, Siamak Daneshmand, Daniel Canter, Yair Lotan, Peter Black, Hamidreza Abdi, Bas van Rhijn, Elisabeth Fransen van de Putte, Peter Boström, Ilmari Koskinen, Piotr Zareba, Janet Baack Kukreja, Wassim Kassouf, Samer Traboulsi, and Jehonathan Pinthus Wilhelmina DuivenvoordenWilhelmina Duivenvoorden More articles by this author , Siamak DaneshmandSiamak Daneshmand More articles by this author , Daniel CanterDaniel Canter More articles by this author , Yair LotanYair Lotan More articles by this author , Peter BlackPeter Black More articles by this author , Hamidreza AbdiHamidreza Abdi More articles by this author , Bas van RhijnBas van Rhijn More articles by this author , Elisabeth Fransen van de PutteElisabeth Fransen van de Putte More articles by this author , Peter BoströmPeter Boström More articles by this author , Ilmari KoskinenIlmari Koskinen More articles by this author , Piotr ZarebaPiotr Zareba More articles by this author , Janet Baack KukrejaJanet Baack Kukreja More articles by this author , Wassim KassoufWassim Kassouf More articles by this author , Samer TraboulsiSamer Traboulsi More articles by this author , and Jehonathan PinthusJehonathan Pinthus More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.383AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Neoadjuvant chemotherapy (NAC), in combination with radical cystectomy (RC), is associated with a significant survival advantage for patients with muscle-invasive bladder cancer. Chemotherapy as well as pelvic surgery are significant risk factors for thrombo-embolic events (TEE). The objectives of this study were to investigate the incidence and characteristics of TEE during and after NAC and subsequent RC for urothelial bladder cancer. METHODS A retrospective analysis of 827 patients who underwent NAC and cystectomy for urothelial bladder carcinoma from 2002 to 2014 at ten different tertiary centers across North America and Europe. The median time of follow-up from bladder cancer diagnosis was 13 months (range 1-119 months). The incidence (venous, arterial, port-site or deep vein thrombosis, thrombosis, clinical or incidentally detected pulmonary embolism) and timing of TEE (before or after (< or > 30 days) RC) and Khorana score (established for cancer patients treated with chemotherapy, based on baseline hemoglobin, platelet and leukocyte counts, BMI and tumor site) was determined for all patients. All patients received TEE prophylaxis during the early post-RC period. Multivariate analysis was performed on 827 patients. Kaplan Meier survival curves and log rank test were used to compare survival between patients who developed TEE and those who did not. RESULTS The Khorana criteria indicated intermediate TEE risk in most patients. Khorana risk score was 1 or 2 in 88% of patients. Overall, the incidence of TEE in patients was 15%. 59 TEE were detected pre-operatively (7.1%), 21 early within 30 days of RC (2.5%) and 36 late post-operatively (4.3%). 32% of the TEE events were detected incidentally by imaging, 68% were detected clinically. Median overall survival of patients who developed TEE was 28 months compared to 71 months for those who did not develop TEE (p=0.012). CONCLUSIONS This multi-centre retrospective study suggests that TEE are very common in bladder cancer patients undergoing NAC before and after RC and they associate with poorer survival. Further investigation with a prospective prevention trial for the period of NAC is warranted. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e652-e653 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Wilhelmina Duivenvoorden More articles by this author Siamak Daneshmand More articles by this author Daniel Canter More articles by this author Yair Lotan More articles by this author Peter Black More articles by this author Hamidreza Abdi More articles by this author Bas van Rhijn More articles by this author Elisabeth Fransen van de Putte More articles by this author Peter Boström More articles by this author Ilmari Koskinen More articles by this author Piotr Zareba More articles by this author Janet Baack Kukreja More articles by this author Wassim Kassouf More articles by this author Samer Traboulsi More articles by this author Jehonathan Pinthus More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...