Abstract

BACKGROUND:

Routine VTE prophylaxis within 30 days of radical cystectomy (RC) for urinary bladder cancer (UBC) is used to protect from venous thromboembolism (VTE). However, randomized studies and nationwide population-based studies are lacking.

OBJECTIVE:

To study VTE and risk factors for VTE in muscle-invasive UBC in a nationwide population-based series, with a focus on the association with RC with and without chemotherapy.

MATERIALS AND METHODS:

We studied all patients with clinical stage T2-T4 UBC diagnosed 1997 to 2014 in the Bladder Cancer Data Base Sweden (BladderBaSe). Previous VTE events and risk factors for VTE were registered from 1987. Cox regression analyses and Kaplan-Meier curves were performed to study risk factors for VTE and cumulative incidence of VTE.

RESULTS:

In 9720 patients (71%males) with a median age of 74 years 546 (5.6%) had VTE after diagnosis. In Cox analyses controlling for patient’s and tumour characteristics, and risk factors for VTE, VTE after diagnosis and first treatment date were associated with chemotherapy with or without RC. Cumulative incidence of VTE increased during 24 months after diagnosis and first treatment date. VTE were less common in patients with previous cardiovascular disease.

CONCLUSIONS:

VTE was commonly observed after 30 days from diagnosis and from first treatment date in patients with T2-T4 UBC, particularly after chemotherapy. The findings suggest that long-term intervention studies of benefit and possible harms of VTE prophylaxis after UBC should be undertaken.

中文翻译：

---

肌肉浸润性膀胱癌中的血栓栓塞。基于人口的全国性研究

摘要

背景：

膀胱癌根治性切除术（RC）在30天内常规预防VTE可用于预防静脉血栓栓塞（VTE）。但是，缺乏随机研究和全国范围的人口研究。

目的：

以全国人群为基础的系列研究在肌肉浸润性UBC中的VTE和VTE危险因素，重点是在有或没有化疗的情况下与RC的关联。

材料和方法：

我们在瑞典的膀胱癌数据库（BladderBaSe）中研究了所有1997年至2014年诊断为T2-T4 UBC临床分期的患者。1987年开始记录以前的VTE事件和VTE危险因素。进行Cox回归分析和Kaplan-Meier曲线研究VTE的危险因素和VTE的累积发生率。

结果：

在诊断后，中位年龄为74岁的9720名患者（占男性的71％）中有546人（占5.6％）患有VTE。在对患者和肿瘤特征以及VTE危险因素进行控制的Cox分析中，诊断和首次治疗日期后的VTE与伴或不伴RC的化疗相关。诊断和首次治疗日期后24个月内，VTE的累积发生率增加。VTE在先前患有心血管疾病的患者中较少见。

结论：

T2-T4 UBC患者通常在诊断后30天和首次治疗日期后观察到VTE，尤其是在化疗后。研究结果表明，应该对UBC后预防VTE的益处和可能的危害进行长期干预研究。