PB0936 - Pre-surgical ovarian vein thrombosis in women with ovarian malignancies as predictor of pulmonary embolism

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Hanke M. Wiegers, MD

PhD Researcher
Department of Obstetrics and Gynaecology, University Medical Centers Amsterdam, University of Amsterdam, Amsterdam, Netherlands
Amsterdam, Noord-Holland, Netherlands

Co-Author(s)

LB

Ludo F. M. Beenen

Radiologist
Department of Radiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
Amsterdam, Noord-Holland, Netherlands
MS

Mirte Schaafsma

MD, PhD student
Antoni van Leeuwenhoek, Netherlands Cancer Institute
Amsterdam, Noord-Holland, Netherlands
Saskia Middeldorp, MD PhD

Professor
Department of Internal Medicine, Radboud university medical center, Nijmegen, The Netherlands
Nijmegen, Gelderland, Netherlands
BH

Barbara A. Hutten

PhD
Department of Epidemiology and Data Science, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
Amsterdam, Noord-Holland, Netherlands
SM

Stijn H. Mom

MD, PhD
Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam Reproduction & Development research institute, Amsterdam, The Netherlands
Amsterdam, Noord-Holland, Netherlands
Luuk J. Scheres, MD, PhD

Internist in training & post-doctoral researcher
Radboud University Medical Center & Leiden University Medical Center
Nijmegen, Gelderland, Netherlands

Background: Ovarian vein thrombosis (OVT) is a rare disorder. Few data are available on the risk factors for OVT. Current evidence suggests a role for local factors, as the risk of OVT is increased during pregnancy, in the postpartum period and in patients with gynaecological malignancies. Furthermore, several case reports have described the occurrence of pulmonary embolism (PE) after OVT.

Aims: To assess the association between preoperative OVT and postoperative PE in women undergoing surgery for an ovarian malignancy.

Methods: In this case-control study women surgically treated for ovarian cancer FIGO stages I-IV were included. Cases were consecutive women with postoperative PE within 90 days after surgery between January 2015 and July 2020, controls were women without postoperative PE within 90 days. Cases were matched (1:2 ratio) by age, malignancy disease stage and type of surgery with controls. Without knowledge of the occurrence of postoperative PE, one experienced radiologist assessed presence of OVT on pre-operative imaging (computed tomography with intravenous contrast).

Results: A total of 57 patients (19 cases, 38 controls) were included, with a median age of 70 years (interquartile range 62–76) and mean BMI of 26 kg/m2 (standard deviation 5.2). Surgeries concerned: interval debulking (54.4%), primary debulking (40.4%) or staging surgery (5.2%) of which 95% were open procedures, and 5% laparoscopic. Of the 19 cases with postoperative PE, two (10.5%, 95% confidence interval [CI] 2.9-31.4) were found to have preoperative OVT, whereas none of the 38 controls (0%) had OVT on pre-operative imaging. In absence of an OVT in the control group, a conservative estimate of the Odds Ratio (assuming 0.5 additional OVT in both cases and controls) would yield: 11.0 (95%CI 0.5 – 241.4).

Conclusion(s): OVT on preoperative imaging might be a predictor of postoperative PE in women with ovarian malignancy. Confirmation from larger studies is needed.