Cancer surgery linked to increased venous thromboembolism risk: JAMA

A recent study highlights the intricate relationship between major cancer surgeries and the subsequent risk of venous thromboembolic events (VTEs). The critical findings of this study were published in a recent issue of the Journal of American Medical Association to underline the nuanced landscape of thromboprophylaxis therapy following cancer surgery.

The retrospective observational matched cohort study covered the entire Swedish population from 1998 to 2016 by including patients who underwent major surgeries for various cancers, including bladder, breast, colon or rectum, gynecologic organs, kidney and upper urothelial tract, lung, prostate, and gastroesophageal tract. This study meticulously matched these patients in a 1:10 ratio with cancer-free individuals with considering factors such as year of birth, sex, and county of residence.

These factors were analyzed from February 13 to December 5, 2023 and revealed a significant 1-year cumulative risk of pulmonary embolism among the cancer surgery population. Also, the risks varied among different cancer types by emphasizing the need for personalized thromboprophylaxis regimens based on the specific surgery and cancer type.

The study reported increased risks within the first 30 days after surgery, with hazard ratios 10 to 30 times higher when compared to the non-cancer cohort. While the risks gradually subsided it did persist for about 2 to 4 months postoperatively, thereby highlighting a critical window for vigilant monitoring and potential intervention.

The outcomes suggest that the increased VTE rate is likely attributed to both the underlying cancer disease and adjuvant treatments. This finding emphasizes the importance of individualized risk assessment and prophylaxis strategies customized to the unique circumstances of every patient undergoing cancer surgery.

Reference:

Björklund, J., Rautiola, J., Zelic, R., Edgren, G., Bottai, M., Nilsson, M., Vincent, P. H., Fredholm, H., Falconer, H., Sjövall, A., Nilsson, P. J., Wiklund, P., Aly, M., & Akre, O. (2024). Risk of venous thromboembolic events after surgery for cancer. JAMA Network Open, 7(2), e2354352. https://doi.org/10.1001/jamanetworkopen.2023.54352