Ovarian vein thrombosis after debulking surgery for ovarian cancer: Epidemiology and clinical significance

Simon Mantha, Debra Sarasohn, Weining Ma, Sean M. Devlin, Dennis S. Chi, Kara Long Roche, Rudy S. Suidan, Kaitlin Woo, Gerald A. Soff

Research output: Contribution to journalArticle

Abstract

Objective Ovarian vein thrombosis is associated with pregnancy and pelvic surgery. Postpartum ovarian vein thrombosis is associated with infection and a high morbidity rate and is treated with anticoagulant and intravenous antibiotic therapy. The natural history of such thrombotic events after debulking surgery for ovarian cancer has not been well described. Our objective was to characterize the presentation and outcomes for patients with this condition at our institution. Study Design We conducted a retrospective study of patients who underwent surgical debulking for ovarian cancer at Memorial Sloan Kettering Cancer Center between the years 2001 and 2010. Patients were included if contrast computed tomography scans of both the abdomen and pelvis were performed within 12 weeks before and 12 weeks after the surgery. The images were reviewed to assess for the presence and extent of a new postoperative ovarian vein thrombosis. When available, subsequent studies were assessed for thrombus progression. Medical records were reviewed to determine whether anticoagulation was used for treatment of the thrombotic episode and to record the occurrence of any new significant venous thromboembolic event in the next year. Results One hundred fifty-nine patients had satisfactory imaging. New ovarian vein thrombosis was a common complication of debulking surgery, as found in 41 of patients (25.8%). Only 5 women with ovarian vein thrombosis were started on anticoagulation, of which 2 individuals had an independent venous thromboembolic event as indication for treatment. Only 2 of the ovarian vein thromboses (4.9%) progressed to the inferior vena cava or left renal vein on subsequent scan. The estimated cumulative incidence of venous thromboembolism 1 year after the first postoperative scan was 17.1% for patients in the new ovarian vein thrombosis group vs 15.3% of individuals for the group without a postoperative ovarian vein thrombosis (P =.78). Conclusion Ovarian vein thrombosis is commonly encountered after debulking surgery for ovarian cancer. Anticoagulation is usually not indicated, and clinically meaningful thrombus progression rarely occurs.

Original languageEnglish (US)
Pages (from-to)208.e1-208.e4
JournalAmerican journal of obstetrics and gynecology
Volume213
Issue number2
DOIs
StatePublished - Aug 1 2015

Keywords

  • debulking surgery
  • ovarian cancer
  • ovarian vein thrombosis

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Mantha, S., Sarasohn, D., Ma, W., Devlin, S. M., Chi, D. S., Roche, K. L., Suidan, R. S., Woo, K., & Soff, G. A. (2015). Ovarian vein thrombosis after debulking surgery for ovarian cancer: Epidemiology and clinical significance. American journal of obstetrics and gynecology, 213(2), 208.e1-208.e4. https://doi.org/10.1016/j.ajog.2015.02.028