Deep vein thrombosis and serum D-dimer after pelvic lymphadenectomy in gynecological cancer

Hiroaki Komatsu, Muneaki Shimada, Daiken Osaku, Imari Deura, Shinya Sato, Tetsuro Oishi, Tasuku Harada

Research output: Contribution to journalArticle

Abstract

Introduction Venous thromboembolism prevention during the perioperative period requires comprehensive risk-level assessment. The aim of this study was to evaluate the incidence of deep vein thrombosis and to assess the cut-off levels of serum D-dimer as a screening strategy for deep vein thrombosis during the perioperative period. Methods A total of 205 patients (ovarian cancer: 68, endometrial cancer: 76, cervical cancer: 61) who underwent gynecological surgery, including retroperitoneal lymph node dissection, were enrolled. We retrospectively analyzed the data on the cut-off value of D-dimer assessed using area under the receiver operating characteristic curve preoperatively, and 2 or 3 months, postoperatively. All patients underwent leg vein ultrasonography regardless of the serum D-dimer level. Furthermore, CT scans were performed to evaluate both disease status and venous thromboembolism, including pulmonary thromboembolism. Statistical analyzes were performed using the Mann-Whitney U-test (D-dimer values of each cancer), Chi-square test, Fisher's exact test (incidence of deep vein thrombosis), and one-way analysis of variance (patient characteristics). Results A total of 205 patients (ovarian cancer: 68, endometrial cancer: 76, cervical cancer: 61) who underwent gynecological surgery, including retroperitoneal lymph node dissection, were included in the analysis. Deep vein thrombosis rates were significantly higher in patients with ovarian cancer (P<0.001). The postoperative D-dimer value was significantly higher than the preoperative value. Postoperative D-dimer values were also significantly higher in patients who received adjuvant chemotherapy (P=0.001). The cut-off value of D-dimer was 1.55 μg/mL preoperatively (sensitivity, 48.0%; specificity, 94.1%), and this value was higher postoperatively, at 1.95 μg/mL (sensitivity, 37.0%; specificity, 90.9%). Conclusion Postoperative D-dimer values are higher not only after surgery but also in patients who received adjuvant chemotherapy. The cut-off value of D-dimer at 2 or 3 months postoperatively was higher than preoperative value.

Original languageEnglish
Pages (from-to)860-864
Number of pages5
JournalInternational Journal of Gynecological Cancer
Volume30
Issue number6
DOIs
Publication statusPublished - 2020 Jun 1

Keywords

  • lymph nodes
  • postoperative period
  • surgical oncology
  • venous thromboembolism

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

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