Meta-Analysis of VTE Risk: Ovarian Cancer Patients by Stage, Histology, Cytoreduction, and Ascites at Diagnosis.

IF 1.6 Q3 OBSTETRICS & GYNECOLOGY Obstetrics and Gynecology International Pub Date : 2020-09-03 eCollection Date: 2020-01-01 DOI:10.1155/2020/2374716
Kristin S Weeks, Emma Herbach, Megan McDonald, Mary Charlton, Marin L Schweizer
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引用次数: 16

Abstract

Venous thromboembolisms (VTEs) have been a leading secondary cause of death among ovarian cancer patients, prompting multiple studies of risk factors. The objective of this meta-analysis is to quantify the associations between VTE and the most commonly reported risk factors among ovarian cancer patients. PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were used to identify observational studies. Two reviewers independently abstracted data and assessed quality via the Newcastle-Ottawa tool. A random effects model was used to calculate the pooled odds ratios for VTE with each of the following exposures: advanced cancer stage, clear cell histology, serous histology, ascites at diagnosis, and complete cytoreduction. The I 2 and Q tests were used to evaluate heterogeneity. Twenty cohort studies with 6,324 total ovarian cancer patients, 769 of whom experienced a VTE, were included. The odds of VTE in ovarian cancer patients were higher among patients with cancer stage III/IV (versus cancer stage I/II, pooled odds ratio (OR) 2.73; 95% CI 1.84-4.06; I 2= 64%), clear cell (versus nonclear cell) histology (OR 2.11; 95% CI 1.55-2.89; I 2 = 6%), and ascites (versus no ascites) at diagnosis (OR 2.12; 95% CI 1.51-2.96; I 2 = 32%). Serous (versus nonserous) histology (OR 1.26; 95% CI 0.91-1.75; I 2 = 42%) and complete (versus incomplete) cytoreduction (OR 1.05; 95% CI 0.27-4.11; I 2 = 88%) were not associated with VTE. This meta-analysis quantifies the significantly elevated odds of VTE in ovarian cancer patients with advanced stage at diagnosis, clear cell histology, and ascites at diagnosis. Further studies are needed to account for confounders and inform clinical decision-making tools.

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静脉血栓栓塞风险的荟萃分析:卵巢癌患者在诊断时的分期、组织学、细胞减少和腹水。
静脉血栓栓塞(vte)已成为卵巢癌患者死亡的主要次要原因,促使多项危险因素的研究。本荟萃分析的目的是量化VTE与卵巢癌患者中最常见的危险因素之间的关系。使用PubMed、Embase和护理及相关健康文献累积索引(CINAHL)来确定观察性研究。两名审稿人独立提取数据并通过Newcastle-Ottawa工具评估质量。采用随机效应模型计算以下暴露情况下静脉血栓栓塞的合并优势比:晚期癌症、透明细胞组织学、浆液组织学、诊断时腹水和完全细胞减少。采用I 2和Q检验评价异质性。20项队列研究共纳入6324例卵巢癌患者,其中769例经历过静脉血栓栓塞。卵巢癌III/IV期患者发生静脉血栓栓塞的几率更高(与I/II期相比,合并优势比(OR) 2.73;95% ci 1.84-4.06;I 2= 64%),透明细胞(相对于非透明细胞)组织学(OR 2.11;95% ci 1.55-2.89;I 2 = 6%),诊断时出现腹水(相对于无腹水)(OR 2.12;95% ci 1.51-2.96;i2 = 32%)。浆液性(vs .非浆液性)组织学(OR 1.26;95% ci 0.91-1.75;I 2 = 42%)和完全(相对于不完全)细胞减少(OR 1.05;95% ci 0.27-4.11;I 2 = 88%)与VTE无关。该荟萃分析量化了诊断为晚期、细胞组织学清晰、诊断为腹水的卵巢癌患者发生静脉血栓栓塞的几率显著升高。需要进一步的研究来解释混杂因素并为临床决策工具提供信息。
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来源期刊
Obstetrics and Gynecology International
Obstetrics and Gynecology International OBSTETRICS & GYNECOLOGY-
CiteScore
3.60
自引率
0.00%
发文量
26
审稿时长
19 weeks
期刊介绍: Obstetrics and Gynecology International is a peer-reviewed, Open Access journal that aims to provide a forum for scientists and clinical professionals working in obstetrics and gynecology. The journal publishes original research articles, review articles, and clinical studies related to obstetrics, maternal-fetal medicine, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine and infertility, reproductive endocrinology, and sexual medicine.
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