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논문 기본 정보

자료유형
학술저널
저자정보
Yoshifumi Takahashi (Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan) Hiroyuki Fujiwara (Jichi Medical University) Kouji Yamamoto (Department of Biostatistics, School of Medicine, Yokohama City University, Kanagawa, Japan) Masashi Takano (National Defense Medical College Hospita) Morikazu Miyamoto (National Defense Medical College Hospita) Kosei Hasegawa (Saitama Medical University International Medical Center) Maiko Miwa (Saitama Medical University International Medical Center) Toyomi Satoh (University of Tsukuba Hospital, Ibaraki, Japan) Hiroya Itagaki (Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan) Takashi Hirakawa (Department of Obstetrics and Gynecology, Gunma University Graduate School of Medicine, Gunma, Japan) Mayuyo Mori-Uchino (Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan) Tomonori Nagai (Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan) Yoshinobu Hamada (Department of Obstetrics and Gynecology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan) Soichi Yamashita (Department of Gynecology, Gunma Prefectural Cancer Center, Gunma, Japan) Hiroko Yano (Department of Gynecologic Oncology, Hyogo Cancer Center, Hyogo, Japan) Tomoyasu Kato (National Cancer Center Hospital, Tokyo, Japan) Keiichi Fujiwara (Saitama Medical University International Medical Center, Hidaka, Japan) Mitsuaki Suzuki (Department of Obstetrics and Gynecology, Shin-Yurigaoka General Hospital, Kanagawa, Japan)
저널정보
대한부인종양학회 Journal of Gynecologic Oncology Journal of Gynecologic Oncology Vol.35 No.4
발행연도
2024.7
수록면
1 - 14 (14page)
DOI
https://doi.org/10.3802/jgo.2024.35.e37

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초록· 키워드

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Objective: In Japan, perioperative prophylaxis of pulmonar y embolism (PE) in gynecologiccancer patients with preoperative asymptomatic venous thromboembolism (VTE) has notbeen well established yet. The GOTIC-VTE trial was a prospective, multi-center, single-armclinical trial to investigate the prevention of postoperative symptomatic PE onset by seamlessanticoagulant therapy from the preoperative period to 4 weeks after surger y instead of usingintermittent pneumatic compression. Methods: Anticoagulant therapy was started immediately after asymptomatic VTE diagnosisand stopped preoperatively according to the rules of each institution. Unfractionatedheparin administration was resumed within 12 hours postoperatively, and this was followedby the switch to low-molecular-weight heparin and subsequently, edoxaban; this cycle wascontinued for 28 days. Primar y outcome was the occurrence of symptomatic PE in 28 dayspostoperatively. Secondar y outcomes were the incidence of VTE-related events in 28 days and6 months postoperatively and protocol-related adverse events. Results: Between Februar y 2018 and September 2020, 99 patients were enrolled; of these, 82 patients were assessed as the full analysis set, including 58 for ovarian cancer, fallopian tube,or peritoneal cancer; 21 for endometrial cancer; and 3 for cer vical cancer. No symptomatic PEwas obser ved within 28 days postoperatively; two patients had bleeding events (major bleedingand clinically relevant nonmajor bleeding) and three had grade 3 adverse events (increasedalanine transaminase, aspartate aminotransferase, or gamma-glutamyl transferase). Conclusion: The multifaceted perioperative management for gynecologic malignancies withasymptomatic VTE effectively prevented postoperative symptomatic PE. Trial Registration: JRCT Identifier: jRCTs031180124
#Anticoagulants #Gynecologic Neoplasms #Gynecologic Surger y #Pulmonar y Embolism #Venous Thromboembolism

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