Evaluation of the hypercoagulable state of gynecologic cancer patients by thromboelastography: a prospective pilot study and a review of the literature

Objective: Cancer patients are at risk for developing venous thromboembolism (VTE). The present authors assessed the value of using thrombelastography (TEG) to evaluate the coagulation state of women with various forms of gynecological disorders. Materials and Methods: Surgical patients with gynecological malignancy (study group, n = 65, 71%) were prospectively compared to patients with premalignant and benign disease (control group, n = 19, 29%). Routine blood tests and TEG results were collected one day prior to surgery. Clinical and laboratory data were collected from the medical charts. Univariate and multivariate analyses were performed to determine group differences. Results: The study patients included 15 (23%) women with endometrial, 22 (33.8%) with ovarian, and nine (13.8%) with uterine cervical cancer. They were significantly older, had a higher body mass index, and more comorbidities, all known risk factors to develop VTE, compared to the control group. Surprisingly, TEG parameters were similar for both groups except for the α angle (time of clot formation), that was wider in the study group (76.6 ± 3.43º vs. 74.66 ± 3.66º, p = 0.044, non-significant on multivariate analysis). Conclusions: The pre-surgical/basal TEG profile is similar for gynecological patients with malignant and benign disease and therefore does not differentiate between them in terms of greater risk of VTE.

Thrombelastography; Hypercoagulability; Gynecologic cancer.

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