The impact of venous thromboembolism on the outcomes of patients with cervical carcinoma, a retrospective analysis at a single institution

Abstract

Background: Venous thromboembolism (VTE) is a frequent cause of morbidity in patients with cervical cancer. The aim of this study was to investigate the survival outcomes of patients with cervical cancer and VTE in a South African population. Material and methods: The records of 47 cervical cancer patients with a concomitant diagnosis of a deep vein thrombosis (DVT)/VTE who were admitted to the radiation oncology ward at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in 2015 and 2016 were identified and analysed retrospectively. Data collected included the age, stage, human immunodeficiency virus (HIV) status and details of diagnosis of VTE and the treatment received. The survival of patients from diagnosis of VTE and the two-year overall survival (OS) rate was calculated using the Kaplan–Meier method. Univariate and multivariate analyses of factors influencing survival were performed on selected clinical variables. Results: The majority of patients (60%) had stage IIIB cervical cancer; 60% of patients were HIV-positive. The median survival of patients from the time of diagnosis of VTE was 2.7 months (interquartile range [IQR]: 0.97–6.93 months) and the 12-month survival from diagnosis of VTE for this cohort was 17%. Once a VTE was diagnosed the survival becomes poor irrespective of age, stage or HIV status. The two-year OS of this cohort from date of diagnosis of cancer was 29.8%. Patients who were diagnosed with a VTE before or during radiotherapy had a significantly lower OS than that of patients who were diagnosed with a VTE after radiotherapy (12.5% versus 38.7%), p = 0.004. Conclusion: The diagnosis of VTE is a poor prognostic factor in patients with locally advanced cervical cancer.