Key result
Postoperative VTE is linked to ~109% higher mortality risk after retroperitoneal tumor surgery.
Why the study?
Venous thromboembolism is a common postoperative complication, but its incidence and risk stratification in patients with retroperitoneal tumor remained unclear.
What are the incidence, risk factors, and outcomes of venous thromboembolism in patients undergoing surgery for retroperitoneal tumors?
Cohort (n=1,223)
What are the incidence, risk factors, and outcomes of venous thromboembolism in patients undergoing surgery for retroperitoneal tumors?
Hazard Ratio: 2.09 (95% CI 1.014–4.308)
p-value: p=0.046
Postoperative VTE occurs in 2.1% of patients undergoing retroperitoneal tumor surgery and is associated with older age, tumor recurrence, vascular resection, and worse overall survival.
Postoperative VTE signals higher mortality risk after retroperitoneal tumor surgery; hypothesis-generating and requires prospective validation before changing practice.
BACKGROUND: Venous thromboembolism (VTE) is a common postoperative complication; however, the incidence and risk stratification of postoperative VTE in patients with retroperitoneal tumor remains unclear. The authors aim to quantify the incidence, identify risk factors, and determine the outcomes of VTE in patients undergoing retroperitoneal tumor surgery. METHODS: The authors retrospectively reviewed the characteristics, perioperative outcomes, and overall survival (OS) of patients (VTE and non-VTE) who underwent retroperitoneal tumor surgery between 2015 and 2020. Perioperative and oncologic outcomes were compared using propensity-matching and Cox analyses. RESULTS: Of 1223 patients with retroperitoneal tumor surgery, 2.1% had VTE. Age [odds ratio (OR) 1.140, 95% CI: 1.053-1.239, P =0.004], recurrence (OR 1.851, 95% CI: 1.241-2.761, P =0.003), and vascular resection (OR 2.036, 95% CI: 1.054-3.934, P =0.034) were independent risk factors, with significant between-group differences regarding age, recurrence, sarcoma, organ resection, vascular resection, and operation time. No between-group differences in 30-day all-cause mortality (8 vs. 4%, OR 0.657, 95% CI: 0.375-1.151, P =0.427) and major complications (12 vs. 8%, OR 0.775, 95% CI: 0.483-1.244, P =0.572) were observed. Mean hospitalization duration (20.1 vs. 22.9 days, OR 1.153, 95% CI: 1.022-1.386, P =0.033) and ICU stay (3.2 vs. 5.5 days, OR 1.193, 95% CI: 1.034-1.347, P =0.012) were shorter in non-VTE versus VTE, respectively, with inferior OS (hazard ratio 2.090, 95% CI: 1.014-4.308, P =0.046) in VTE. CONCLUSIONS: Age, recurrence, and vascular resection are positively associated with VTE, which is associated with inferior OS.
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Guo et al. (2023) conducted a cohort in Retroperitoneal tumors (n=1,223). Venous thromboembolism (VTE) vs. No VTE was evaluated on Overall survival (HR 2.090, 95% CI 1.014-4.308, p=0.046). Postoperative venous thromboembolism occurred in 2.1% of patients undergoing retroperitoneal tumor surgery and was associated with inferior overall survival (HR 2.090; 95% CI 1.014-4.308; P=0.046).
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