PRELIMINARY-STUDY TO IDENTIFY CANCER-PATIENTS AT HIGH-RISK OF VENOUS THROMBOSIS FOLLOWING MAJOR SURGERY

This study investigated whether the pre-surgical plasma levels of TAT and F1 + 2 of patients undergoing major surgery for localized tumours could identify patients at higher risk of thrombosis, and how heparin prophylaxis affected in vivo coagulation after cancer surgery. We meas ured the pre- and post-operative levels of TAT, F1 + 2, total factor V II (FVIIt) and zymogen FVII (FVIIz) in 117 cancer patients, with and w ithout heparin prophylaxis. The end points of this study were DVT, ini tially detected by I-125-fibrinogen uptake test and confirmed by ascen ding venography. Pre-operative [TAT] and [F1 + 2] of the cancer patien ts were significantly higher than those of age-matched control subject s (n = 50) (P<0.005 and P<0.05, respectively); pre-operative [FVII] wa s not significantly different. One of the 83 patients receiving prophy laxis, and 8/34 not receiving prophylaxis developed post-operative DVT . Of the parameters evaluated, only the pre-operative [TAT]>3.5 ng/ml identified patients at higher risk for post-operative DVT. Heparin red uced plasma TAT levels and FVII consumption following surgery, suggest ing that heparin modulates coagulation associated with cancer surgery. The results of this study also suggest that the pre-operative [TAT] m ay identify patients with higher risk for post-operative DVT.