1Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
2Hematologic Oncology Clinics, Center for Specific Organs Cancer, National Cancer Center, Goyang, Korea
3Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
4Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
Copyright © 2016 by the Korean Cancer Association
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Variable | Cohort A (n=400) | Cohort B (n=148) | p-value |
---|---|---|---|
Age, median (range, yr) | 64 (21-95) | 65 (33-89) | 0.582a) |
Sex | |||
Male | 248 (62.0) | 79 (53.4) | 0.078b) |
Female | 152 (38.0) | 69 (46.6) | |
BMI | 23.04±3.29 | 23.38±3.48 | 0.296a) |
No. of comorbidities | |||
0 | 196 (49.0) | 79 (53.4) | 0.139c) |
1 | 124 (31.0) | 49 (33.1) | |
≥ 2 | 80 (20.0) | 20 (13.5) | |
White blood cell count (/μL) | 6,058±2,137 | 5,951±1,791 | 0.560a) |
Hemoglobin (g/dL) | 12.6±1.8 | 12.4±2.1 | 0.274a) |
Platelet count (/μL) | 241±77 | 251±74 | 0.153a) |
D-dimer (μg/mL) | 0.92±1.80 | 0.94±1.60 | 0.894a) |
< 0.5 | 174 (43.5) | 67 (45.3) | 0.719c) (0.673d)) |
≥ 0.5 | 140 (35.0) | 59 (39.9) | |
Not checked | 86 (21.5) | 22 (14.9) | |
Tumor stage | |||
0-1 | 72 (18.0) | 37 (25.0) | 0.010a) |
2 | 83 (20.8) | 42 (28.4) | |
3 | 174 (43.5) | 55 (37.2) | |
4 | 71 (17.8) | 14 (9.5) | |
Tumor location | |||
Right colon cancere) | 80 (20.0) | 35 (23.6) | 0.296c) |
Left colon cancerf) | 147 (36.8) | 55 (37.2) | |
Rectal cancerg) | 173 (43.2) | 58 (39.2) | |
Histologic differentiation | |||
WDAC | 39 (9.8) | 16 (10.8) | 0.701c) |
MDAC | 319 (79.8) | 114 (77.0) | |
PDAC | 29 (7.2) | 11 (7.4) | |
Others | 13 (3.2) | 7 (4.7) | |
Preoperative treatment | |||
None | 344 (86.0) | 128 (86.5) | 0.935c) |
Chemotherapy | 14 (3.5) | 3 (2.0) | |
CCRT | 42 (10.5) | 17 (11.5) | |
Operation time (min) | 194.8±100.5 | 175.6±85.2 | 0.027a) |
Operation type | |||
Open | 121 (30.2) | 29 (19.6) | 0.013b) |
Laparoscopy | 279 (69.8) | 119 (80.4) |
Values are presented as number (%) or mean±standard deviation unless otherwise indicated. BMI, body mass index; WDAC, well differentiated adenocarcinoma; MDAC, moderately differentiated adenocarcinoma; PDAC, poorly differentiated adenocarcinoma; CCRT, concurrent chemoradiation therapy.
a) Student’s t test,
b) Fisher exact test (2-sided),
c) Linear-by-linear association,
d) Fisher exact test excluding the missing data,
e) Right colon cancer included primary tumors located in the cecum, ascending colon, hepatic flexure, and transverse colon,
f) Left colon cancer included primary tumors located in the splenic flexure, descending colon, and sigmoid colon,
g) Rectal cancer included primary tumors located in the rectum or rectosigmoid junction.
Sex/Age (yr) | Comorbidity | Stage | Surgical procedure | Surgical outcome | Operation time (min) | VTE event | Time to VTE after surgery (day) | Treatment |
---|---|---|---|---|---|---|---|---|
M/63 | None | IIIC | Hartmann’s operation (open) | R0 | 445 | Asymptomatic PE | 15 | LMWH |
F/85 | DM, HTN | I | Anterior resection (laparoscopic) | R0 | 130 | Asymptomatic proximal DVT (left popliteal vein) | 8 | Observationa) |
F/73 | HTN | IVB | Abdominoperineal resection (laparoscopic) | R2 | 260 | Asymptomatic distal DVT (left calf vein) | 10 | Observationa) |
M/74 | HTN, CVA, dyslipidemia, dementia | IIIA | Subtotal colectomy (laparoscopic) | R0 | 235 | Asymptomatic distal DVT (right calf vein) | 7 | Observationa) |
M/77 | HTN, CKD | IIIC | Right hemicolectomy (laparoscopic) | R0 | 215 | Asymptomatic distal DVT (right calf vein) | 5 | Observationa) |
M/80 | CAD, COPD, asthma | IVA | Low anterior resection and hepatic metastasectomy (open) | R0 | 245 | Symptomatic distal DVT (bilateral leg edema, both calf veins) | 13 | LMWH |
M/75 | HTN | IIIC | Subtotal colectomy (open) | R0 | 200 | Asymptomatic proximal DVT (right superficial femoral vein) | 9 | LMWH |
M/66 | HTN, COPD | IIIB | Pelvic exenteration (open) | R0 | 825 | Asymptomatic proximal DVT (right superficial femoral vein) | 9 | LMWH |
M/72 | DM | IIA | Right hemicolectomy (laparoscopic) | R0 | 190 | Asymptomatic distal DVT (right calf vein) | 6 | Observationb) |
F/79 | HTN | I | Ultralow anterior resection (laparoscopic) | R0 | 185 | Asymptomatic distal DVT (right calf vein) | 5 | Observationb) |
F/80 | HTN | IIA | Right hemicolectomy (laparoscopic) | R0 | 100 | Asymptomatic distal DVT (left calf vein) | 8 | Observationb) |
F/82 | HTN, dyslipidemia | IVA | Abdominoperineal resection (open) | R2 | 165 | Asymptomatic distal DVT (left calf vein) | 8 | LMWH |
VTE, venous thromboembolisms; M, male; F, female; PE, pulmonary embolism; LMWH, low-molecular weight heparin; DM, diabetes mellitus; HTN, hypertension; DVT, deep vein thrombosis of the lower extremities; CVA, cerebrovascular accident; CKD, chronic kidney disease; CAD, coronary artery disease; COPD, chronic obstructive pulmonary disease.
a) No follow-up Doppler ultrasonography on the lower extremities was performed, and no recurrence or aggravation of the deep vein thromboses was observed during follow-up,
b) Follow-up Doppler ultrasonography on the lower extremities was performed and the deep vein thromboses that had developed in the calf veins disappeared spontaneously without treatment.
Variable | VTE (–) (n=388) | VTE (+) (n=12) | p-value |
---|---|---|---|
Age (yr) | |||
< 70 | 252 (99.2) | 2 (0.8) | 0.001a) |
≥ 70 | 136 (93.2) | 10 (6.8) | |
Sex | |||
Male | 241 (97.2) | 7 (2.8) | 0.772a) |
Female | 147 (96.7) | 5 (3.3) | |
BMI, mean (kg/m2) | |||
< 25 | 297 (97.1) | 9 (2.9) | 1.000a) |
≥ 25 | 91 (96.8) | 3 (3.2) | |
No. of comorbidities | |||
0 | 195 (99.5) | 1 (0.5) | 0.001b) |
1 | 119 (96) | 5 (4) | |
≥ 2 | 74 (72.5) | 6 (7.5) | |
White blood cell count (/μL) | |||
≤ 10,000 | 369 (97.6) | 9 (2.4) | 0.023a) |
> 10,000 | 19 (86.4) | 3 (13.6) | |
Hemoglobin level (g/dL) | |||
< 10.0 | 32 (94.1) | 2 (5.9) | 0.271a) |
≥ 10.0 | 356 (97.3) | 10 (2.7) | |
Platelet count (/μL) | |||
≤ 400,000 | 375 (97.2) | 11 (2.8) | 0.352a) |
> 400,000 | 13 (92.9) | 1 (7.1) | |
D-dimer (μg/mL) | |||
< 0.5 | 173 (99.4) | 1 (0.6) | 0.003b) (0.006c)) |
≥ 0.5 | 131 (93.6) | 9 (6.4) | |
Not checked | 84 (97.7) | 2 (2.3) | |
Tumor stage | |||
0-1 | 70 (97.2) | 2 (2.8) | 0.614b) |
2 | 81 (97.6) | 2 (2.4) | |
3 | 169 (97.1) | 5 (2.9) | |
4 | 68 (95.8) | 3 (4.2) | |
Tumor location | |||
Right colon cancere) | 77 (96.2) | 3 (3.8) | 0.761b) |
Left colon cancerf) | 143 (97.3) | 4 (2.7) | |
Rectal cancerg) | 168 (97.1) | 5 (2.9) | |
Histologic differentiation | |||
WDAC | 39 (100) | 0 | 0.415b) |
MDAC | 309 (96.9) | 10 (3.1) | |
PDAC | 27 (93.1) | 2 (6.9) | |
Others | 13 (100) | 0 | |
Preoperative treatment | |||
None | 333 (96.8) | 11 (3.2) | 0.661b) |
Chemotherapy | 14 (100) | 0 | |
CCRT | 41 (97.6) | 1 (2.4) | |
Operation time (min) | 193±96 | 266±196 | 0.220d) |
Operation type | |||
Open | 117 (96.7) | 4 (3.3) | 0.759a) |
Laparoscopy | 271 (97.1) | 8 (2.9) | |
Surgical outcome | 0.648b) | ||
R0 | 341 (97.2) | 10 (2.8) | |
R1 or R2 | 47 (95.9) | 2 (4.1) |
Values are presented as number (%) or mean±standard deviation. VTE, venous thromboembolisms; BMI, body mass index; WDAC, well differentiated adenocarcinoma; MDAC, moderately differentiated adenocarcinoma; PDAC, poorly differentiated adenocarcinoma; CCRT, concurrent chemoradiation therapy.
a) Fisher exact test (2-sided),
b) Linear-by-linear association,
c) Fisher exact test excluding the missing data,
d) Student’s t test,
e) Right colon cancer included primary tumors located in the cecum, ascending colon, hepatic flexure, and transverse colon,
f) Left colon cancer included primary tumors located in the splenic flexure, descending colon, and sigmoid colon,
g) Rectal cancer includes primary tumors located in the rectum or rectosigmoid junction.
All of the clinical parameters that were measured or examined preoperatively in this study were included. BMI, body mass index; WDAC, well differentiated adenocarcinoma; MDAC, moderately differentiated adenocarcinoma; PDAC, poorly differentiated adenocarcinoma; CCRT, concurrent chemoradiation therapy.
Variable | Cohort A (n=400) | Cohort B (n=148) | p-value |
---|---|---|---|
Age, median (range, yr) | 64 (21-95) | 65 (33-89) | 0.582 |
Sex | |||
Male | 248 (62.0) | 79 (53.4) | 0.078 |
Female | 152 (38.0) | 69 (46.6) | |
BMI | 23.04±3.29 | 23.38±3.48 | 0.296 |
No. of comorbidities | |||
0 | 196 (49.0) | 79 (53.4) | 0.139 |
1 | 124 (31.0) | 49 (33.1) | |
≥ 2 | 80 (20.0) | 20 (13.5) | |
White blood cell count (/μL) | 6,058±2,137 | 5,951±1,791 | 0.560 |
Hemoglobin (g/dL) | 12.6±1.8 | 12.4±2.1 | 0.274 |
Platelet count (/μL) | 241±77 | 251±74 | 0.153 |
D-dimer (μg/mL) | 0.92±1.80 | 0.94±1.60 | 0.894 |
< 0.5 | 174 (43.5) | 67 (45.3) | 0.719 |
≥ 0.5 | 140 (35.0) | 59 (39.9) | |
Not checked | 86 (21.5) | 22 (14.9) | |
Tumor stage | |||
0-1 | 72 (18.0) | 37 (25.0) | 0.010 |
2 | 83 (20.8) | 42 (28.4) | |
3 | 174 (43.5) | 55 (37.2) | |
4 | 71 (17.8) | 14 (9.5) | |
Tumor location | |||
Right colon cancer |
80 (20.0) | 35 (23.6) | 0.296 |
Left colon cancer |
147 (36.8) | 55 (37.2) | |
Rectal cancer |
173 (43.2) | 58 (39.2) | |
Histologic differentiation | |||
WDAC | 39 (9.8) | 16 (10.8) | 0.701 |
MDAC | 319 (79.8) | 114 (77.0) | |
PDAC | 29 (7.2) | 11 (7.4) | |
Others | 13 (3.2) | 7 (4.7) | |
Preoperative treatment | |||
None | 344 (86.0) | 128 (86.5) | 0.935 |
Chemotherapy | 14 (3.5) | 3 (2.0) | |
CCRT | 42 (10.5) | 17 (11.5) | |
Operation time (min) | 194.8±100.5 | 175.6±85.2 | 0.027 |
Operation type | |||
Open | 121 (30.2) | 29 (19.6) | 0.013 |
Laparoscopy | 279 (69.8) | 119 (80.4) |
Sex/Age (yr) | Comorbidity | Stage | Surgical procedure | Surgical outcome | Operation time (min) | VTE event | Time to VTE after surgery (day) | Treatment |
---|---|---|---|---|---|---|---|---|
M/63 | None | IIIC | Hartmann’s operation (open) | R0 | 445 | Asymptomatic PE | 15 | LMWH |
F/85 | DM, HTN | I | Anterior resection (laparoscopic) | R0 | 130 | Asymptomatic proximal DVT (left popliteal vein) | 8 | Observation |
F/73 | HTN | IVB | Abdominoperineal resection (laparoscopic) | R2 | 260 | Asymptomatic distal DVT (left calf vein) | 10 | Observation |
M/74 | HTN, CVA, dyslipidemia, dementia | IIIA | Subtotal colectomy (laparoscopic) | R0 | 235 | Asymptomatic distal DVT (right calf vein) | 7 | Observation |
M/77 | HTN, CKD | IIIC | Right hemicolectomy (laparoscopic) | R0 | 215 | Asymptomatic distal DVT (right calf vein) | 5 | Observation |
M/80 | CAD, COPD, asthma | IVA | Low anterior resection and hepatic metastasectomy (open) | R0 | 245 | Symptomatic distal DVT (bilateral leg edema, both calf veins) | 13 | LMWH |
M/75 | HTN | IIIC | Subtotal colectomy (open) | R0 | 200 | Asymptomatic proximal DVT (right superficial femoral vein) | 9 | LMWH |
M/66 | HTN, COPD | IIIB | Pelvic exenteration (open) | R0 | 825 | Asymptomatic proximal DVT (right superficial femoral vein) | 9 | LMWH |
M/72 | DM | IIA | Right hemicolectomy (laparoscopic) | R0 | 190 | Asymptomatic distal DVT (right calf vein) | 6 | Observation |
F/79 | HTN | I | Ultralow anterior resection (laparoscopic) | R0 | 185 | Asymptomatic distal DVT (right calf vein) | 5 | Observation |
F/80 | HTN | IIA | Right hemicolectomy (laparoscopic) | R0 | 100 | Asymptomatic distal DVT (left calf vein) | 8 | Observation |
F/82 | HTN, dyslipidemia | IVA | Abdominoperineal resection (open) | R2 | 165 | Asymptomatic distal DVT (left calf vein) | 8 | LMWH |
Variable | VTE (–) (n=388) | VTE (+) (n=12) | p-value |
---|---|---|---|
Age (yr) | |||
< 70 | 252 (99.2) | 2 (0.8) | 0.001 |
≥ 70 | 136 (93.2) | 10 (6.8) | |
Sex | |||
Male | 241 (97.2) | 7 (2.8) | 0.772 |
Female | 147 (96.7) | 5 (3.3) | |
BMI, mean (kg/m2) | |||
< 25 | 297 (97.1) | 9 (2.9) | 1.000 |
≥ 25 | 91 (96.8) | 3 (3.2) | |
No. of comorbidities | |||
0 | 195 (99.5) | 1 (0.5) | 0.001 |
1 | 119 (96) | 5 (4) | |
≥ 2 | 74 (72.5) | 6 (7.5) | |
White blood cell count (/μL) | |||
≤ 10,000 | 369 (97.6) | 9 (2.4) | 0.023 |
> 10,000 | 19 (86.4) | 3 (13.6) | |
Hemoglobin level (g/dL) | |||
< 10.0 | 32 (94.1) | 2 (5.9) | 0.271 |
≥ 10.0 | 356 (97.3) | 10 (2.7) | |
Platelet count (/μL) | |||
≤ 400,000 | 375 (97.2) | 11 (2.8) | 0.352 |
> 400,000 | 13 (92.9) | 1 (7.1) | |
D-dimer (μg/mL) | |||
< 0.5 | 173 (99.4) | 1 (0.6) | 0.003 |
≥ 0.5 | 131 (93.6) | 9 (6.4) | |
Not checked | 84 (97.7) | 2 (2.3) | |
Tumor stage | |||
0-1 | 70 (97.2) | 2 (2.8) | 0.614 |
2 | 81 (97.6) | 2 (2.4) | |
3 | 169 (97.1) | 5 (2.9) | |
4 | 68 (95.8) | 3 (4.2) | |
Tumor location | |||
Right colon cancer |
77 (96.2) | 3 (3.8) | 0.761 |
Left colon cancer |
143 (97.3) | 4 (2.7) | |
Rectal cancer |
168 (97.1) | 5 (2.9) | |
Histologic differentiation | |||
WDAC | 39 (100) | 0 | 0.415 |
MDAC | 309 (96.9) | 10 (3.1) | |
PDAC | 27 (93.1) | 2 (6.9) | |
Others | 13 (100) | 0 | |
Preoperative treatment | |||
None | 333 (96.8) | 11 (3.2) | 0.661 |
Chemotherapy | 14 (100) | 0 | |
CCRT | 41 (97.6) | 1 (2.4) | |
Operation time (min) | 193±96 | 266±196 | 0.220 |
Operation type | |||
Open | 117 (96.7) | 4 (3.3) | 0.759 |
Laparoscopy | 271 (97.1) | 8 (2.9) | |
Surgical outcome | 0.648 |
||
R0 | 341 (97.2) | 10 (2.8) | |
R1 or R2 | 47 (95.9) | 2 (4.1) |
Variable | Odds ratio | 95% Confidence interval | p-value |
---|---|---|---|
Age (yr) | |||
< 70 | 1.00 | - | - |
≥ 70 | 5.61 | 1.02-30.91 | 0.048 |
No. of comorbidities | 0.070 | ||
0 | 1.00 | - | - |
1 | 5.61 | 0.60-52.80 | 0.132 |
≥ 2 | 13.42 | 1.38-130.88 | 0.025 |
White blood cell count (/μL) | - | - | - |
≤ 10,000 | 1.00 | - | - |
> 10,000 | 17.43 | 2.76-109.96 | 0.002 |
D-dimer (μg/mL) | 0.223 | ||
< 0.5 | 1.00 | - | - |
≥ 0.5 | 5.01 | 0.57-44.28 | 0.147 |
Not checked | 1.82 | 0.14-24.57 | 0.651 |
Variable | Odds ratio | 95% Confidence interval | p-value |
---|---|---|---|
Age (yr) | |||
< 70 | 1.00 | - | - |
≥ 70 | 7.43 | 1.06-51.95 | 0.043 |
Sex | |||
Male | 1.00 | - | - |
Female | 0.92 | 0.23-3.67 | 0.900 |
BMI | |||
< 25 | 1.00 | - | - |
≥ 25 | 0.93 | 0.17-5.01 | 0.935 |
No. of comorbidities | 0.063 | ||
0 | 1.00 | - | - |
1 | 8.10 | 0.63-104.35 | 0.109 |
≥ 2 | 22.59 | 1.53-333.47 | 0.023 |
White blood cell count (/μL) | |||
≤ 10,000 | 1.00 | - | - |
> 10,000 | 17.96 | 2.45-131.87 | 0.005 |
Platelet count (/μL) | |||
≤ 400,000 | 1.00 | - | - |
> 400,000 | 7.43 | 0.43-128.12 | 0.168 |
Hemoglobin concentration (g/dL) | |||
≥ 10.0 | 1.00 | - | - |
< 10.0 | 1.30 | 0.17-9.84 | 0.801 |
D-dimer level (μg/mL) | 0.303 | ||
< 0.5 | 1.00 | - | - |
≥ 0.5 | 4.44 | 0.48-41.34 | 0.191 |
Not checked | 1.68 | 0.10-27.87 | 0.717 |
Tumor stage | 0.967 | ||
0-1 | 1.00 | - | - |
2 | 0.55 | 0.06-5.52 | 0.611 |
3 | 0.72 | 0.10-5.06 | 0.738 |
4 | 0.68 | 0.06-8.03 | 0.756 |
Tumor location | 0.923 | ||
Right colon cancer | 1.00 | - | - |
Left colon cancer | 0.85 | 0.15-4.93 | 0.853 |
Rectal cancer | 1.18 | 0.20-7.00 | 0.855 |
Histology | |||
WDAC/MDAC | 1.00 | - | - |
PDAC/Others | 1.48 | 0.16-13.52 | 0.729 |
Preoperative treatment | |||
No | 1.00 | - | - |
Yes (chemotherapy or CCRT) | 1.10 | 0.09-13.22 | 0.938 |
Operation type | |||
Laparoscopic | 1.00 | - | - |
Open | 0.85 | 0.17-4.12 | 0.839 |
Values are presented as number (%) or mean±standard deviation unless otherwise indicated. BMI, body mass index; WDAC, well differentiated adenocarcinoma; MDAC, moderately differentiated adenocarcinoma; PDAC, poorly differentiated adenocarcinoma; CCRT, concurrent chemoradiation therapy. Student’s t test, Fisher exact test (2-sided), Linear-by-linear association, Fisher exact test excluding the missing data, Right colon cancer included primary tumors located in the cecum, ascending colon, hepatic flexure, and transverse colon, Left colon cancer included primary tumors located in the splenic flexure, descending colon, and sigmoid colon, Rectal cancer included primary tumors located in the rectum or rectosigmoid junction.
VTE, venous thromboembolisms; M, male; F, female; PE, pulmonary embolism; LMWH, low-molecular weight heparin; DM, diabetes mellitus; HTN, hypertension; DVT, deep vein thrombosis of the lower extremities; CVA, cerebrovascular accident; CKD, chronic kidney disease; CAD, coronary artery disease; COPD, chronic obstructive pulmonary disease. No follow-up Doppler ultrasonography on the lower extremities was performed, and no recurrence or aggravation of the deep vein thromboses was observed during follow-up, Follow-up Doppler ultrasonography on the lower extremities was performed and the deep vein thromboses that had developed in the calf veins disappeared spontaneously without treatment.
Values are presented as number (%) or mean±standard deviation. VTE, venous thromboembolisms; BMI, body mass index; WDAC, well differentiated adenocarcinoma; MDAC, moderately differentiated adenocarcinoma; PDAC, poorly differentiated adenocarcinoma; CCRT, concurrent chemoradiation therapy. Fisher exact test (2-sided), Linear-by-linear association, Fisher exact test excluding the missing data, Student’s t test, Right colon cancer included primary tumors located in the cecum, ascending colon, hepatic flexure, and transverse colon, Left colon cancer included primary tumors located in the splenic flexure, descending colon, and sigmoid colon, Rectal cancer includes primary tumors located in the rectum or rectosigmoid junction.
The four variables that showed statistical significance in the univariate analyses were included.
All of the clinical parameters that were measured or examined preoperatively in this study were included. BMI, body mass index; WDAC, well differentiated adenocarcinoma; MDAC, moderately differentiated adenocarcinoma; PDAC, poorly differentiated adenocarcinoma; CCRT, concurrent chemoradiation therapy.