TITLE

Venous Thromboembolism in Patients with Primary Bone or Soft-Tissue Sarcomas

AUTHOR(S)
Mitchell, Sheryl Y.; Lingard, Elizabeth A.; Kesteven, Patrick; McCaskie, Andrew W.; Gerrand, Craig H.
PUB. DATE
November 2007
SOURCE
Journal of Bone & Joint Surgery, American Volume;Nov2007, Vol. 89-A Issue 11, p2433
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Venous thromboembolism has been independently associated with both malignant disease and orthopaedic surgery. Patients with bone or soft-tissue tumors who undergo orthopaedic surgery may therefore be at high risk for thromboembolic events. The purpose of the present retrospective study was to determine the rate of clinically detected deep venous thrombosis and pulmonary embolism in patients with trunk or extremity bone or soft-tissue sarcomas. Methods: The medical records of patients with a confirmed diagnosis of primary bone or soft-tissue sarcoma who had presented to our unit between 1998 and 2003 were reviewed with use of a standardized chart abstraction tool. The data that were retrieved included patient-related data (demographic characteristics, diagnoses, and surgical interventions), the use of adjuvant chemotherapy or radiation therapy, additional risk factors for thromboembolism, the use of thromboembolic prophylaxis, and confirmed thromboembolic events. Results: Of the 252 patients who were identified, ninety-four had a diagnosis of primary bone sarcoma and 158 had a diagnosis of primary soft-tissue sarcoma. Approximately 70% of the cohort received thromboprophylaxis, with 57% receiving low-molecular-weight heparin. Thirty-seven patients were clinically suspected of having a deep venous thrombosis. Nine patients had a deep venous thrombosis that was confirmed radiographically, and in one case the diagnosis was made at another center, resulting in a rate of clinically evident deep venous thrombosis of 4%. Nine patients had a clinically suspected pulmonary embolism. One patient had confirmation of the pulmonary embolism with use of a ventilation-perfusion scan, one patient died of pulmonary embolism, and one patient had diagnosis of the pulmonary embolism at another center, resulting in an overall rate of pulmonary embolism of 1.2% and a rate of fatal pulmonary embolism of 0.4%. All patients with thromboembolic events had a tumor involving the hip or thigh, with the majority of the events occurring prior to definitive surgery. Conclusions: The risk of a clinically apparent thromboembolic event in patients with bone or soft-tissue sarcomas is comparable with that in other orthopaedic patients. However, tumors in the hip or thigh may be associated with a particularly high risk of thromboembolism. A prospective study is needed to investigate factors that are predictive of thromboembolism and the role of chemical thromboprophylaxis. Level of Evidence: Prognostic Level IV. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
27430003

 

Related Articles

  • Extraskeletal osteosarcoma with rhabdomyosarcomatous differentiation in local recurrence and lung metastases or so-called malignant mesenchymoma of soft tissue: A phenomenon related with chemotherapy? Percinel, Sibel; Sak, Serpil Dizbay; Erinanc, Hilal; Savas, Berna; Sertcelik, Ayse; Okten, Ilker // Internet Journal of Pediatrics & Neonatology;2008, Vol. 7 Issue 1, p6 

    Extraskeletal osteosarcoma (ESOS), the soft tissue counterpart of primary skeletal osteosarcoma, is a rare tumor. Although rhabdomyosarcomatous differentiation may be seen in a variety of sarcomas, it has not been described in an ESOS. We report a case of ESOS, osteoblastic type, in the right...

  • Aktueller Stand der neoadjuvanten Therapie bei Weichteilsarkomen. Lehnhardt, M.; Schmitt, T.; Bischof, M.; Daigeler, A.; Egerer, G. // Der Chirurg;Nov2011, Vol. 82 Issue 11, p995 

    The treatment of soft tissue sarcoma is clinically challenging. Referral to an experienced center with an interdisciplinary team is strongly recommended. Neoadjuvant therapy, including irradiation and chemotherapy, has been applied to improve local control rates, eradicate micrometastases and...

  • Intensified adjuvant IFADIC chemotherapy in combination with radiotherapy versus radiotherapy alone for soft tissue sarcoma: long-term follow-up of a prospective randomized feasibility trial. Fakhrai, Negar; Ebm, Claudia; Kostler, Wolfgang J.; Jantsch, Marion; Abdolvahab, Farshid; Dominkus, Martin; Pokrajac, Boris; Kauer-Dorner, Daniela; Zielinski, Christoph C.; Brodowicz, Thomas // Wiener Klinische Wochenschrift;Nov2010, Vol. 122 Issue 21/22, p614 

    djuvant chemotherapy for grade 2 and 3 soft tissue sarcoma (STS) patients still has to be considered experimental. Fifty-nine patients underwent primary surgery by wide or marginal excision and were subsequently randomized to receive radiotherapy alone or in combination with six courses of...

  • Blood transfusion requirements for patients with sarcomas undergoing combined radio- and chemotherapy. Sherbourne, Karen R.; Earl, Helena M.; Whitehead, Lynne; Jefferies, Sarah J.; Burnet, Neil G. // Sarcoma;Sep-Dec2005, Vol. 9 Issue 3/4, p119 

    Patients with bony and soft tissue sarcomas may require intensive treatment with chemotherapy and radiotherapy, which often leads to a fall in haemoglobin levels, requiring blood transfusion. There may be advantages in predicting which patients will require transfusion, partly because anaemia...

  • Metastasis of Osteosarcoma to Soft Tissue. Damron, Timothy A.; Morganti, Chris; Yang, Yi; Hojnowski, Leonard; Cherny, Richard // Journal of Bone & Joint Surgery, American Volume;Nov2000, Vol. 82-A Issue 11, p1634 

    Focuses on the need to consider metastatic disease as a possible explanation for any soft-tissue mass that is discovered at the time of diagnosis, or during treatment, of osteosarcoma. Case report of the disease; Swelling of the distal part of the right thigh; Diagnosis of soft-tissue metastasis.

  • Validation of radiographic response evaluation criteria of preoperative chemotherapy for bone and soft tissue sarcomas: Japanese Orthopaedic Association Committee on Musculoskeletal Tumors Cooperative Study. Takafumi Ueda; Norifumi Naka; Nobuhito Araki; Takeshi Ishii; Hiroyuki Tsuchiya; Hideki Yoshikawa; Kazuo Mochizuki; Tadao Tsuboyama; Junya Toguchida; Toshifumi Ozaki; Hiroaki Murata; Ikuo Kudawara; Kazuhiro Tanaka; Yukihide Iwamoto; Yasuo Yazawa; Kazuyoshi Kushida; Takanobu Otsuka; Keiji Sato // Journal of Orthopaedic Science;Jul2008, Vol. 13 Issue 4, p304 

    Abstract Background  The radiographic evaluation of the response to preoperative chemotherapy for bone and soft tissue sarcomas is based mostly on the change in primary tumor size before and after chemotherapy, as is done for many solid cancers. Its prognostic correlation, however, has...

  • Regional hyperthermia plus chemotherapy increased survival in soft-tissue sarcoma. Adams, Stacey L.; Haigh, Christen // Hem/Onc Today;10/25/2009, Vol. 10 Issue 20, p14 

    The article discusses research on the benefit of a combination of chemotherapy and regional hyperthermia in patients with high-risk soft-tissue sarcoma, presented by lead researcher Rolf Issels, at the joint 15th European CanCer Organization and 34th European Society for Medical Oncology...

  • Diagnosis and management of soft tissue sarcoma. Sinha, Shiba; Peach, A. Howard S. // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;1/15/2011, Vol. 342 Issue 7789, p157 

    The article offers clinical information on soft tissue sarcoma, a heterogeneous group of tumors of mesodermal origin. Soft tissue sarcoma may occur at any age, with rhabdomyosarcoma being the most common in children and young adults. It may be de nove, radiation-induced or associated with...

  • Retroperitoneal and Visceral Sarcomas: Issues for the General Surgeon. Woodall, Charles E.; Scoggins, Charles R. // American Surgeon;Jun2007, Vol. 73 Issue 6, p631 

    Sarcomas represent a rare, heterogeneous group of malignant tumors that arise from the mesenchymal tissues of the body. Although infrequently encountered, these tumors generate vigorous academic interest and an ever-expanding volume of medical literature. Chemotherapy is widely regarded as...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics