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Thromboembolism in Muscle-Invasive Bladder Cancer. A Population-based Nationwide Study
Department of Clinical and Experimental Medicine, Division of Urology, Linkoping University, Linkoping, Sweden.
Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden.
Department of Pelvic Surgery, Karolinska University Hospital, Stockholm, Sweden.
Department of Urology, School of Medical Sciences, Faculty of Medicine and Health, Orebro University, Orebro, Sweden.
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2021 (English)In: Bladder Cancer, ISSN 2352-3727, Vol. 7, no 2, p. 161-171Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
IOS Press, 2021. Vol. 7, no 2, p. 161-171
Keywords [en]
Bladder cancer, chemotherapy, cystectomy, population-based, prophylaxis, venous thromboembolism
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:umu:diva-184210DOI: 10.3233/BLC-200409ISI: 000656306100005Scopus ID: 2-s2.0-85106929050OAI: oai:DiVA.org:umu-184210DiVA, id: diva2:1564054
Funder
Swedish Cancer Society, 2016/470Swedish Cancer Society, 2017/278Available from: 2021-06-11 Created: 2021-06-11 Last updated: 2023-09-05Bibliographically approved

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Sherif, AmirSöderström, KarinHäggström, Christel

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