The factors affecting the survivability of malignant cancer patients with deep vein thrombosis among subjects with gynecologic and non-gynecologic cancer: An ambispective cohort study

Abstract

Background Gynecologic cancer is a significant public health concern worldwide, with three of the top ten most common cancers affecting women. The increasing incidence of deep vein thrombosis (DVT) and the disproportionately poor outcomes in cancer patients necessitates urgent intervention. This study aimed to analyze the factors affecting the survivability of cancer patients with DVT, especially among gynecologic and non-gynecologic cancers. Methods An ambispective cohort study was conducted among gynecologic and non-gynecologic cancer patients with DVT, from January 2011 until August 2013. All subjects were observed for three months. The presence of DVT was confirmed using Doppler ultrasound. The analysis was performed using Kaplan-Meier survival analysis. The statistical significance was determined using the log-rank/Mantel-Cox test. Results Among 223 cancer subjects with DVT, 61.4% of the subjects developed short-term mortality. In the overall group, the survival time was significantly lower in subjects who developed immobilization status (p-value <0.001), advanced cancer stages (p-value <0.045), and infection status (p-value <0.001). In the gynecologic cancer group, the survival time was significantly lower in subjects who developed immobilization (p-value 0.007) and infection status (p-value 0.021). In the non-gynecologic cancer group, the survival time was significantly lower in subjects who developed immobilization (p-value 0.008), infection (p-value 0.002), undergo cancer surgery (p-value 0.024), and received high-risk systemic therapy (p-value 0.048). Additionally, the most common infection was pneumonia (29.6%). Conclusions Both gynecologic and non-gynecologic cancer patients who experienced DVT developed a high short-term mortality. Our finding of immobility, infection, advanced cancer stages, systemic therapy, and cancer surgery as risk factors that affect the survivability highlights the necessity of administering secondary prophylaxis as a standard procedure in clinical practice.