Pulmonary embolism in patients receiving chemotherapy for advanced ovarian cancer

The incidence of pulmonary embolism was examined in a series of 83 patients who had received chemotherapy for advanced ovarian cancer and ten embolic episodes occurred. The incidence of pulmonary emboli was highest in those patients who had gross bulk disease (greater than 10 cm diameter) before chemotherapy and occurred in 9/49 cases, with all six fatalities being in this group. Five of the six fatal emboli occurred within 1 week of the first course of chemotherapy. As the mortality rate from pulmonary emboli in patients with gross bulk tumour was 12% in this series, anticoagulation before initiating chemotherapy is suggested for this group of patients.