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DVT rate of 2% seen in lower extremity tumor cases with prophylactic treatment
SAN DIEGO — Deep venous thrombosis rarely occurred in a prospective study of patients undergoing surgery for lower extremity tumor resection, according to investigators here.
Patrick P. Lin, MD, of Houston, discussed the outcomes of the 50-patient case-controlled cohort at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).
“Venous thromboembolism is serious and potentially fatal in all patients with surgery. The patients in orthopedic oncology are especially high risk both because they have malignancy and because they are undergoing orthopedic surgery,” he said.
Lin and colleagues investigated the use of dalteparin (Fragmin; Pfizer) in their study. He said the relevant AAOS guidelines call for using aspirin, warfarin or no chemoprophylactic measures at all in this high-risk population.
Twenty-five patients with metastatic disease and 25 patients with sarcoma tumors received 5,000 daily units of dalteparin, which was administered subcutaneously starting at 12 to 24 hours postoperatively.
The patients were not randomized, which Lin cited as a study weakness.
However, all patients were screened with ultrasound before surgery and just prior to discharge to check for pulmonary emboli, deep venous thrombosis (DVT) or other thromboembolic events. One patient in the metastatic group developed a DVT, Lin said.
Based on these results, “We feel routine screening with ultrasound is not necessary,” Lin said.
Reference:
- Lin PP, et al. DVT prophylaxis with dalteparin for malignant tumor resection. Paper #525. Presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons. Feb. 15-19, 2011. San Diego.
Disclosure: Pfizer funded this study.
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