Ovarian vein thrombosis after debulking surgery for ovarian cancer: Epidemiology and clinical significance Journal Article


Authors: Mantha, S.; Sarasohn, D.; Ma, W.; Devlin, S. M.; Chi, D. S.; Roche, K. L.; Suidan, R. S.; Woo, K.; Soff, G. A.
Article Title: Ovarian vein thrombosis after debulking surgery for ovarian cancer: Epidemiology and clinical significance
Abstract: Objective Ovarian vein thrombosis is associated with pregnancy and pelvic surgery. Postpartum ovarian vein thrombosis is associated with infection and a high morbidity rate and is treated with anticoagulant and intravenous antibiotic therapy. The natural history of such thrombotic events after debulking surgery for ovarian cancer has not been well described. Our objective was to characterize the presentation and outcomes for patients with this condition at our institution. Study Design We conducted a retrospective study of patients who underwent surgical debulking for ovarian cancer at Memorial Sloan Kettering Cancer Center between the years 2001 and 2010. Patients were included if contrast computed tomography scans of both the abdomen and pelvis were performed within 12 weeks before and 12 weeks after the surgery. The images were reviewed to assess for the presence and extent of a new postoperative ovarian vein thrombosis. When available, subsequent studies were assessed for thrombus progression. Medical records were reviewed to determine whether anticoagulation was used for treatment of the thrombotic episode and to record the occurrence of any new significant venous thromboembolic event in the next year. Results One hundred fifty-nine patients had satisfactory imaging. New ovarian vein thrombosis was a common complication of debulking surgery, as found in 41 of patients (25.8%). Only 5 women with ovarian vein thrombosis were started on anticoagulation, of which 2 individuals had an independent venous thromboembolic event as indication for treatment. Only 2 of the ovarian vein thromboses (4.9%) progressed to the inferior vena cava or left renal vein on subsequent scan. The estimated cumulative incidence of venous thromboembolism 1 year after the first postoperative scan was 17.1% for patients in the new ovarian vein thrombosis group vs 15.3% of individuals for the group without a postoperative ovarian vein thrombosis (P =.78). Conclusion Ovarian vein thrombosis is commonly encountered after debulking surgery for ovarian cancer. Anticoagulation is usually not indicated, and clinically meaningful thrombus progression rarely occurs. © 2015 Elsevier Inc.
Keywords: treatment outcome; cancer surgery; major clinical study; cancer patient; treatment indication; ovarian cancer; cytoreductive surgery; computer assisted tomography; ovary cancer; anticoagulant therapy; retrospective study; postoperative complication; vein thrombosis; cancer epidemiology; abdominal radiography; anticoagulant agent; debulking surgery; pelvis radiography; human; female; priority journal; article; ovarian vein thrombosis
Journal Title: American Journal of Obstetrics and Gynecology
Volume: 213
Issue: 2
ISSN: 0002-9378
Publisher: Elsevier Inc.  
Date Published: 2015-08-01
Start Page: 208.e1
End Page: 208.e4
Language: English
DOI: 10.1016/j.ajog.2015.02.028
PROVIDER: scopus
PUBMED: 25743130
PMCID: PMC4863445
DOI/URL:
Notes: Export Date: 2 September 2015 -- Source: Scopus
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MSK Authors
  1. Dennis S Chi
    707 Chi
  2. Weining Ma
    40 Ma
  3. Gerald A Soff
    93 Soff
  4. Sean McCarthy Devlin
    601 Devlin
  5. Rudy Sam Joseph Suidan
    11 Suidan
  6. Simon H Mantha
    67 Mantha
  7. Kaitlin Marie Woo
    101 Woo