L. A. DeCesare1, E. M. Ritz1, C. M. O’Donoghue1 1Rush University Medical Center,Chicago, IL, USA
Introduction:
Venous thromboembolism (VTE), either deep vein thrombosis or pulmonary embolism, is one of the leading causes of postoperative morbidity and mortality in cancer patients. VTE risk differs depending on type of malignancy. Using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), we evaluated the incidence of VTE in patients undergoing surgical excision for cutaneous malignancies.
Methods:
A retrospective cohort study of patients undergoing cutaneous excisions was performed using the ACS NSQIP database (2008-2017). CPT codes were used to identify patients who had undergone surgical excision for benign or malignant disease. Patients were categorized by the presence of cutaneous malignancy (melanoma, basal cell carcinoma, squamous cell carcinoma) or the absence of cutaneous malignancy using ICD codes. The incidence of 30-day postoperative VTE was compared between groups. We further evaluated VTE incidence between various procedure types using CPT codes.
Results:
Twenty-nine VTE events were found among 15,169 patients. The incidence of VTE for patients with cutaneous malignancy was 0.18% (9/4,901) while the incidence of VTE for patients without cutaneous malignancy was 0.19% (20/10,239) (P=0.8778). No difference was found when comparing VTE incidence between melanoma (0.21%), basal cell carcinoma (0.18%), squamous cell carcinoma (0.13%), and benign pathology (0.20%) (P=0.9777). Additionally, no difference was found when comparing VTE incidence between various procedure types, including benign excision (0.19%), malignant excision (0.07%), malignant excision and sentinel lymph node biopsy (0.25%), malignant excision and lymph node dissection (0.88%), malignant excision with reconstruction (0.38%), and malignant excision with reconstruction with either sentinel lymph node biopsy or dissection (0%) (P=0.1456).
Conclusion:
Cutaneous malignancy does not appear to be associated with VTE in patients undergoing surgical excision. Therefore, the decision for perioperative anticoagulation should be determined by individual patient risk factors.
