The impact of venous thromboembolism on the outcomes of patients with cervical carcinoma: a retrospective audit from January 2015 to December 2016
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Date
2020
Authors
Shiba, Preyesh Thakorbhai Goven
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Abstract
Background
Venous thromboembolism (VTE) is a frequent cause of morbidity in patients with
cervical cancer. The aim of this study was to investigate the outcomes of patients
with cervical cancer and a deep vein thrombosis (DVT) in a South African population.
Methods
The records of 47 cervical cancer patients with a concomitant diagnosis of a deep
vein thrombosis (DVT) /VTE who were admitted to the radiation oncology ward at
Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in 2015 and 2016
were identified and analysed retrospectively. Data collected included the age, stage,
Human Immunodeficiency Virus (HIV) status and details of diagnosis of VTE and the
treatment received. The survival of patients from diagnosis of VTE and the 2 year
overall survival (OS) rate was calculated using the Kaplan and Meier method.
Univariate and multivariate analyses of factors influencing survival were performed
on selected clinical variables.Results
Forty seven patients had a concomitant diagnosis of cervical cancer and VTE. The
majority of patients (60%) had stage IIIB cervical cancer. Sixty percent of patients
were HIV positive and 40% of patients were HIV negative. The median survival of
patients from the time of diagnosis of VTE was 2.7 months, (interquartile range (IQR):
0.97 – 6.93 months) and the 12 month survival from diagnosis of VTE for this cohort
was 17%. Once a deep venous thrombosis was diagnosed the survival becomes
poor irrespective of age, stage, HIV status. The 2 year overall survival of this cohort
was 29.8%. The 2 year overall survival of patients who were diagnosed with a DVT
before or during radiotherapy was significantly lower than that of patients who were
diagnosed with DVT after radiotherapy, (12.5% versus 38.7%), p = 0.004.
The diagnosis of DVT / VTE is a poor prognostic factor in patients with locally
advanced cervical cancer.
Description
A research report submitted n partial fulfillment of the requirements for the degree
Master of Medicine in the branch of Radiation Oncology to the Faculty of Health Sciences, University of
the Witwatersrand, Johannesburg 2020