HealthDay News — Patients with muscle invasive bladder cancer who undergo neoadjuvant chemotherapy before and after radical cystectomy frequently experience thromboembolic events, according to a study published in The Journal of Urology.
Wilhelmina CM Duivenvoorden, PhD, from McMaster University and Juravinski Hospital in Hamilton, Canada, and colleagues conducted a multi-institutional retrospective analysis of 761 patients who underwent neoadjuvant chemotherapy and radical cystectomy for muscle invasive bladder cancer. Patients were followed for a median of 21.4 months from diagnosis.
The researchers found that based on the Khorana score, 88% of patients had an intermediate thromboembolic event risk. In patients undergoing neoadjuvant chemotherapy, the overall incidence of thromboembolic events was 14%, with variation from 5 to 32% among institutions. Compared to patients without a thromboembolic event, patients with thromboembolic events were older and received a longer neoadjuvant chemotherapy course. Overall, 58% of thromboembolic events developed preoperatively and 72% were symptomatic. The development of a thromboembolic event was not associated with reduced overall survival on multivariable analysis. Adverse risk factors for survival included pathologic stage and high Khorana score.
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“Thromboembolic events are common in patients with muscle invasive bladder cancer who undergo neoadjuvant chemotherapy before and after radical cystectomy,” the authors write. “Our results suggest that a prospective trial of thromboembolic event prophylaxis during neoadjuvant chemotherapy is warranted.”
Reference
- Duivenvoorden WCM, Daneshmand S, Canter D, et al. Incidence, Characteristics and Implications of Thromboembolic Events in Patients with Muscle Invasive Urothelial Carcinoma of the Bladder Undergoing Neoadjuvant Chemotherapy. J Urol. 2016 December. DOI: http://dx.doi.org/10.1016/j.juro.2016.06.017
