Decreased survival in cervical cancer patients with thromboembolic events
16034 Background: We have previously reported on the incidence of thromboembolic events (TE) in cervical cancer patients treated with definitive chemoradiation.Patients with TE seemed to have decreased survival compared to those without TE. We reviewed a larger cohort to compare the survival of cervical cancer patients with and without TE. Materials and Methods: We performed a retrospective chart review of cervical cancer patients diagnosed and treated at the University for Iowa from January 1997 until December 2003. Data sources included the University of Iowa Tumor Registry, the Gynecologic Oncology Tumor Data Base, and the relevant ICD-9 codes to identify cervical carcinoma and types of TE in both inpatients and outpatients. Statistical analysis included the Pearson chi-squared test for categorical variable, and the two-sample t-test for continuous factors. Log-rank tests were used for survival analysis along with the generation of Kaplan-Meier survival curves. Multivariate analysis was performed with Cox proportional hazards regression. All tests are two sided and carried out at the 5% level of significance. Results: Three hundred and fifty nine (359) patients were treated with surgery or chemoradiation; thirty-six patients (10%) developed TE. There were significant associations between thromboembolic status and pelvic irradiation (p=0.0493), chemotherapy (p=0.0118), and stage (p=0.0197). Survival could not be estimated for patients not experiencing a thromboembolism; survival did not drop below 50% by the end of follow-up. Median survival time for patients with thromboembolism was 4.5 years. According to log-rank test, this difference was significant (p-value<0.0001). Conclusion: The incidence of thromboembolic events in this cohort of cervical cancer patients was 10%. TE was associated with a significant decrease in survival. No significant financial relationships to disclose.