Stratification of venous thromboembolism risk in ovarian cancer patients during chemotherapy

Background: The prevalence of venous thromboembolism (VTE) in ovarian cancer during first-line chemotherapy (CHT) ranges between 6.4% and 10.6%. Identification of the susceptible population is crucial for effective thromboprophylaxis. Methods: We performed a retrospective study of all our patients with epithelial ovarian cancer who underwent ambulatory first-line CHT between 1990 and 2004. Data were collected regarding age, body mass index (BMI), previous deep vein thrombosis, pulmonary embolism (PE), menopause status, FIGO stage, grade, histology, type of surgery, residual disease, and CHT. Univariable and multivariable regression analyses were performed to assess independent prognostic factors for VTE/PE to calculate a prognostic index (PI). Results: Of 203 patients, 16 (7.8%) had symptomatic VTE: 15 deep vein thrombosis and 1 PE. Multivariable regression analysis found that age (P = 0.01), BMI (P = 0.01), and stage (P = 0.05) were independent prognostic factors for VTE. Age, BMI, and stage were used to calculate the PI: 0.285 × age + 0.555 × BMI + 1.110 × stage. The PI was dichotomized according to its median cutoff (5.8) to define a low (3.8% at 6 months) and a high (11.3%) VTE incidence group. Conclusions: Age, BMI, and stage permit to identify ovarian cancer patients with a high risk in developing symptomatic VTE during CHT. ©2009 by IGCS and ESGO.