Thromboembolism in Muscle-Invasive Bladder Cancer. A Population-based Nationwide Study

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Routine VTE prophylaxis within 30 days of radical cystectomy (RC) for urinary bladder cancer (UBC) is used to protect from venous thromboembolism (VTE). However, randomized studies and nationwide population-based studies are lacking. OBJECTIVE: To study VTE and risk factors for VTE in muscle-invasive UBC in a nationwide population-based series, with a focus on the association with RC with and without chemotherapy. MATERIALS AND METHODS: We studied all patients with clinical stage T2-T4 UBC diagnosed 1997 to 2014 in the Bladder Cancer Data Base Sweden (BladderBaSe). Previous VTE events and risk factors for VTE were registered from 1987. Cox regression analyses and Kaplan-Meier curves were performed to study risk factors for VTE and cumulative incidence of VTE. RESULTS: In 9720 patients (71%males) with a median age of 74 years 546 (5.6%) had VTE after diagnosis. In Cox analyses controlling for patient's and tumour characteristics, and risk factors for VTE, VTE after diagnosis and first treatment date were associated with chemotherapy with or without RC. Cumulative incidence of VTE increased during 24 months after diagnosis and first treatment date. VTE were less common in patients with previous cardiovascular disease. CONCLUSIONS: VTE was commonly observed after 30 days from diagnosis and from first treatment date in patients with T2-T4 UBC, particularly after chemotherapy. The findings suggest that long-term intervention studies of benefit and possible harms of VTE prophylaxis after UBC should be undertaken.

Details

Authors
Organisations
External organisations
  • Linköping University
  • Danderyd Hospital
  • Karolinska University Hospital
  • Örebro University
  • Skåne University Hospital
  • Uppsala University
  • Umeå University
  • Sahlgrenska Academy
  • Sahlgrenska University Hospital
  • King's College London
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology
  • Urology and Nephrology

Keywords

  • Bladder cancer, chemotherapy, cystectomy, population-based, prophylaxis, venous thromboembolism
Original languageEnglish
Pages (from-to)161-171
Number of pages11
JournalBladder Cancer
Volume7
Issue number2
Publication statusPublished - 2021
Publication categoryResearch
Peer-reviewedYes