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The development of venous thromboembolism (VTE) after a radical cystectomy is associated with inferior long-term survival of bladder cancer, according to an article in BJU International. This association could mean that VTE is a marker of more aggressive disease. 

Malignancy is a well-established risk factor for VTE. Patients who receive chemotherapy have an even greater risk of VTE, which is a highly morbid event and a common cause of perioperative fatality in patients undergoing surgical resection of their malignancy. Christopher Doiron and colleagues used the population-based Ontario Cancer Registry to investigate the incidence of VTE in patients who underwent a radical cystectomy between 1994 and 2008. 

Of the 3879 patients who underwent a radical cystectomy in the province of Ontario between 1994 and 2008, 211 patients were diagnosed with a VTE, 116 of these patients presented after discharge from hospital.

“We were surprised at the number of patients that were diagnosed with VTE after hospital discharge", said Dr. D. Robert Siemens, senior author of the BJU International study. "Furthermore, we were unable to identify strong predictive factors associated with VTE, suggesting to us that most all patients should receive prolonged VTE prophylaxis well beyond their hospital discharge." Dr. Siemens noted that the fact that a VTE was associated with shorter survival was also intriguing and suggests that this could represent a marker of more aggressive disease. 

Sources: Wiley en BJU International

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