Risk Factors for Epithelial Ovarian Cancer-Associated Venous
Thromboembolism were not Identical on Different Continents
Abstract
Objective: To confirm the differences in the risk factors for epithelial
ovarian cancer-associated venous thromboembolism (EOC-VTE) among
patients on different continents. Methods: We reviewed all EOC-VTE cases
from two tertiary hospitals for ten years. Multivariate logistic
regression analysis was used to identify significant risk factors for
VTE. Then we searched the literature on EOC-VTE risk assessments. The
risk factors presented in the acquired literature and our data were
evaluated by meta-analysis. Two subgroups, according to the continents
mentioned in the studies, were set as Asia and Europe & America,
respectively for analyzation. Results: A total of 122 patients with
EOC-VTE were included. We found six significant risk factors for VTE
among cases of EOC by multivariate logistic regression analysis. Among
the 2064 initial articles, only 30 met the inclusion criteria. Including
our data, there were cumulative 1432 cases and 9874 controls. The
meta-analysis selected 13 out of 23 possible risk factors. Risk factors
were not identical between subgroups. Except for five same elements, the
Asia subgroup had six other significant risk factors for EOC-VTE that
were preoperative D-Dimer > 0.3mg/L (OR: 5.030, 95% CI:
2.003-12.635), surgery time ≥ 180min (OR: 3.459, 95% CI: 2.198-5.441),
WHO performance status score > 1 (OR: 2.847, 95% CI:
1.840-4.405), hypertension (OR: 1.945, 95% CI: 1.238-3.058), age ≥ 60
years (OR: 1.821, 95% CI: 1.374-2.413) and preoperative blood platelet
> 300 × 109/L (OR: 1.532, 95% CI: 1.025-2.289).
Accordingly, another two significant risk factors were found in Europe
& America subgroup, which were the initial FIGO stage (Ⅲ/Ⅳ) (OR: 2.837,
95% CI: 2.147-3.748) and postmenopausal status (OR: 1.926, 95% CI:
1.025-3.622). Six EOC-VTE risk factors in our data were covered by the
11 risk factors of Asian subgroup analyzes. Conclusions: Patients in
Asia and Europe & America have different risk factors for EOC-VTE.