Thromboembolism in Muscle-Invasive Bladder Cancer. A Population-based Nationwide Study

Area of Science:

• Oncology
• Vascular Medicine
• Epidemiology

Background:

• Venous thromboembolism (VTE) prophylaxis is standard after radical cystectomy (RC) for urinary bladder cancer (UBC).
• Limited data exist from randomized or population-based studies on VTE risk in UBC patients.

Purpose of the Study:

• To investigate VTE incidence and risk factors in muscle-invasive UBC.
• To assess the association of VTE with radical cystectomy (RC) and chemotherapy in UBC patients.

Main Methods:

• Nationwide population-based study of 9720 patients with T2-T4 UBC diagnosed 1997-2014.
• Utilized Bladder Cancer Data Base Sweden (BladderBaSe) with VTE data from 1987.
• Employed Cox regression and Kaplan-Meier analyses to identify VTE risk factors and cumulative incidence.

Main Results:

• 5.6% of patients experienced VTE after diagnosis.
• VTE was associated with chemotherapy, with or without RC, after adjusting for confounders.
• VTE incidence increased up to 24 months post-diagnosis/treatment; previous cardiovascular disease was linked to lower VTE risk.

Conclusions:

• VTE is a significant concern in muscle-invasive UBC patients, particularly following chemotherapy.
• Findings support the need for long-term intervention studies on VTE prophylaxis efficacy and safety in UBC survivors.