QLIF-15. PERI-OPERATIVE RISK FACTORS FOR VENOUS THROMBOEMBOLISM DEVELOPMENT IN PATIENTS WITH MALIGNANT GLIOMA

Abstract

BACKGROUND: The cumulative incidence of symptomatic venous thromboembolism (VTE) among patients with malignant gliomas (MG) is estimated to be as high as 36% during the course of therapy and confers a 2-fold increased risk of mortality. The aim of this study was to assess perioperative risk factors that contribute to VTE. METHODS: This retrospective chart review included patients ≥18 years diagnosed with MG (WHO grade 3-4) at the University of Vermont Medical Center from 2009 - 2016. Demographics, surgical details, histological diagnosis and grade as well as peri-operative labs were reviewed on 32 eligible patients. The Khorana scale, a commonly used scoring system to determine risk of VTE development in patients with cancer, was applied. Using SPSS, chi-square tests and univariate models were used to determine the relationship between perioperative risk factors and VTE. RESULTS: Of the 32 patients followed in the study 10 developed VTE (31.2%). The average length of survival was 5.2 months after the development of VTE. Patients who had less than a gross total resection (biopsy or subtotal resection) had a significantly increased risk of developing VTE (p=0.05). The Khorana score had a sensitivity of 76.2% and specificity of 30.0% and was not a statistically significant predictor of VTE (p=0.336). DISCUSSION: Our single institution retrospective study suggests that residual tumor after surgical intervention places MG patients at higher risk for VTE. This study failed to validate use of Khorana score for predicting VTE risk in MG patients due to low specificity, suggesting that patients with MG may have risk for VTE that is unique from other patients with cancer. Because of the high rate of VTE and high prothrombotic potential of patients with MG, further studies are needed to determine whether prophylactic anticoagulant medications may help to reduce risk of VTE.