Key result
Extremity sarcoma resection linked to ~3% VTE risk, with higher rates in bone sarcomas.
Why the study?
Patients undergoing orthopedic surgery for bone or soft tissue sarcoma have increased VTE risk, but thromboprophylaxis guidelines in this population are lacking.
What is the rate of venous thromboembolism in patients undergoing surgical resection for bone and soft tissue sarcoma of the extremities?
Systematic Review
What is the rate of venous thromboembolism in patients undergoing surgical resection for bone and soft tissue sarcoma of the extremities?
Absolute Event Rate: 3.7% vs 1.4%
Patients undergoing surgical resection for extremity sarcomas have a high VTE rate (2.9%), particularly those with bone sarcomas (3.7%), highlighting the need for standardized thromboprophylaxis guidelines.
May support intensified thromboprophylaxis in bone sarcoma resections; leaves open optimal regimens via prospective trials.
BACKGROUND: Patients undergoing an orthopedic surgery for bone or soft tissue sarcoma are at increased venous thromboembolism (VTE) risk. Unfortunately, there is a lack of thromboprophylaxis guidelines in this population. The purpose of this systematic review was to determine the soft tissue and bone sarcoma VTE rate and to explore the thromboprophylaxis regimens used. METHODS: The databases MEDLINE, EMBASE, and CENTRAL were queried using keywords related to VTE and long bone malignancy requiring surgical intervention to 2020. Included studied reported VTE rate in patients with surgically managed extremity sarcoma. Descriptive statistics and weighted mean totals were calculated. RESULTS: A total of 2082 studies were screened and 23 studies were included. The overall VTE rate was 2.9%, with a rate of 3.7% and 1.4% in patients with bone and soft tissue sarcomas, respectively. Low-molecular-weight heparin was the most commonly used chemoprophylaxis. CONCLUSIONS: There is a high VTE rate following sarcoma surgery. The VTE rate is higher in bone sarcoma surgery, which may be attributed to differences in surgery and postoperative recovery. There was no consensus on the duration or type of thromboprophylaxis used. Future research is needed to determine the most effective thromboprophylaxis regimen in patients with sarcoma and whether individualized thromboprophylaxis is required.
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Krzyzaniak et al. (2021) conducted a systematic review in Bone and soft tissue sarcoma of the extremities. Bone sarcoma surgery vs. Soft tissue sarcoma surgery was evaluated on Venous thromboembolism (VTE) rate. Surgical resection for extremity sarcomas is associated with an overall VTE rate of 2.9%, with higher rates in bone sarcoma surgery (3.7%) compared to soft tissue sarcoma surgery (1.4%).
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