Risk of thrombotic complications in patients with ovarian cancer and some safety aspects of using antifibrinolytic hemostatic agents

Deryabina V.A., Matukhin V.I., Rukhliada N.N., Abramova V.N., Kuts E.E.

Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia, Saint Petersburg, Russia

The risk of thrombotic complications is known to increase several times in cancer patients. The malignant process causes changes in the blood coagulation and fibrinolytic systems which negatively affect the prognosis of the patient’s complications. The tumors of the female reproductive system, especially ovarian cancer, are among the most thrombogenic solid tumors. The level of specific markers increases particularly in patients with ovarian cancer. These markers can help to identify patient’s predisposition to the rapid development of venous thromboembolism. There are certain risk factors that increase the likelihood of thrombosis in ovarian cancer: age over 60 years, excess body weight, tumor diameter of more than 100 mm, and the presence of ascites and chronic diseases. Medications used for ovarian cancer are also worth noting. The use of antitumor drugs is known to contribute to thrombotic complications. Conclusion: There is an active discussion about the increased risk of venous thromboembolism in patients who received tranexamic acid and other antifibrinolytic agents to reduce intraoperative blood loss. Although some studies have confirmed the effectiveness of tranexamic acid, there are currently not enough randomized trials to guarantee the absence of a link between the use of antifibrinolytic agents and venous thromboembolism in patients with ovarian cancer. The reasonable use of this group of drugs with obligatory thromboprophylaxis is recommended.

Authors’ contributions: Deryabina V.A., Matukhin V.I., Rukhliada N.N. – developing the concept and design of the study; Deryabina V.A., Matukhin V.I. – collecting and processing the material; Deryabina V.A. – writing the text; Matukhin V.I., Rukhliada N.N., Abramova V.N., Kuts E.E. – editing the article.

Conflicts of interest: The authors declare no possible conflicts of interest.

Funding: The study was conducted without sponsorship.

For citation: Deryabina V.A., Matukhin V.I., Rukhliada N.N., Abramova V.N., Kuts E.E. Risk of thrombotic complications in patients with ovarian cancer and some safety aspects of using antifibrinolytic hemostatic agents. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (10): 60-69 (in Russian) https://dx.doi.org/10.18565/aig.2023.107


ovarian cancer
Trousseau syndrome
venous thromboembolism
tranexamic acid


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Received 28.04.2023

Accepted 26.09.2023

About the Authors

Viktoriya A. Deryabina, 4th year student of the Pediatric Faculty, St. Petersburg State Pediatric Medical University, Ministry of Health of Russia, vika.deryabina@mail.ru,
194100, Russia, St. Petersburg, Litovskaya str., 2.
Valeriy I. Matukhin, Assistant at the Department of Obstetrics and Gynecology, St. Petersburg State Pediatric Medical University, Ministry of Health of Russia,
+7(981)737-04-72, val-matukhin@mail.ru, https://orcid.org/0000-0002-8906-8356, 194100, Russia, St. Petersburg, Litovskaya str., 2.
Nikolai N. Rukhliada, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology, St. Petersburg State Pediatric Medical University, Ministry of Health
of Russia, +7(911)913-20-20, nickolasr@mail.ru, https://orcid.org/0000-0002-3548-0468, 194100, Russia, St. Petersburg, Litovskaya str., 2.
Victoria N. Abramova, obstetrician-gynecologist of the Gynecological Department, St. Petersburg State Pediatric Medical University, Ministry of Health of Russia,
abramova_vn@mail.ru, 194100, Russia, St. Petersburg, Litovskaya str., 2.
Elena E. Kuts, Assistant of the Department of Obstetrics and Gynecology, St. Petersburg State Pediatric Medical University, Ministry of Health of Russia,
elenakuts999@gmail.com, 194100, Russia, St. Petersburg, Litovskaya str., 2.
Corresponding author: Elena E. Kuts, elenakuts999@gmail.com

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