Metabolic syndrome as a risk factor for vascular complications in patients with endometrial cancer

Lapina I.A., Gavrilov M.V., Taranov V.V., Dobrokhotova Yu.E., Koltinova T.G.

Department of Obstetrics and Gynecology, Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia

Endometrial cancer remains one of the most important issues in gynecologic oncology, it requires timely diagnosis as well as prevention of adverse postoperative outcomes. Endometrial cancer is associated with high risk of developing venous thromboembolic complications, particularly in patients with obesity. Therefore, patients at high risk need rational prevention of thromboembolic complications.
Objective. To determine the activation level of hemostasis system in patients with endometrial cancer for analyzing the effectiveness and safety of treatment with antithrombotic therapy when surgeries are performed.
Materials and methods. The study included 80 patients diagnosed with a verified diagnosis of endometrial cancer, including 56 cases staged T1bNxMx, and 24 cases staged T2aNxMx. All patients underwent laparoscopic total hysterectomy, adnexal surgery and pelvic lymphodenectomy. In order to perform comparative analysis of hemostasis system and to study the effectiveness of antithrombotic therapy, the patients were divided into two groups according to pathogenetic patterns: patients with normal body weight (n = 40) and patients with obesity (n = 40). The main parameters of hemostasis system in both groups were analyzed, and mutation in genes affecting hemostasis in such patients was revealed. Forty women were healthy controls.
Results. According to the study, the functional reserves of hemostasis system are more diminished in obese patients with endometrial cancer than in patients with normal body weight, therefore it is necessary to perform effective antithrombotic therapy. Preoperative anticoagulant therapy in combination with postoperative treatment with preparation Fluxum may prevent the development of venous thromboembolic complications even in patients at high risk.
Conclusion. Taking into consideration the unstable hemostasis system in obese patients with endometrial cancer, the use of parnaparin-natrium (Fluxum) appeared to be highly effective in the prevention of thrombotic complications after surgery in patients with endometrial cancer.

Keywords

References

About the Authors

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Received 31.05.2019
Accepted 21.06.2109

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