[Risk and prevention of thromboembolism complications in gynecologic malignancies]

Gynecologic malignancies are often associated with deep vein thrombosis and pulmonary embolism, even before treatment is begun. But such complications also happen during treatment, also if thromboembolism prophylaxis is performed. The incidence of pulmonary embolism before treatment was investigated using scintigraphy. In a retrospective and in a prospective randomized trial, various methods of thromboembolism prophylaxis were evaluated during primary or postoperative radiation therapy. Pulmonary embolism was present in 11.9% of the patients admitted with uterine malignancy. Retrospectively, there were deep vein thromboses in 6.8%, pulmonary embolisms in 3.8% and bleeding complications in 5.3% of the patients receiving thromboembolism prophylaxis with acenocoumarol during radiation therapy of cervical and endometrial cancer. In the prospective study, deep vein thromboses occurred in 1.5%, pulmonary embolisms in 5.9% and bleedings in 2.2%, with both the LMW heparin and the acenocoumarol groups presenting similar results. Thromboembolism is a frequent paraneoplasia of uterine malignancies. The prevention of thromboembolic complications during radiation therapy of uterine malignancies is efficacious and safe using either LMW heparin or acenocoumarol.