Venous Thromboembolism Rate in Patients with Bladder Cancer According to the Type of Treatment: A systematic review

Abstract

Background: Bladder cancer (BC) is classified as a high-risk tumor type for Venous Thrombo Embolism (VTE). VTE presents an extra challenge in the management of patients with cancer, given the increase in morbidity and mortality in having both conditions.
Objective: To summarise the contemporary evidence on the VTE rate in patients with BC according to the stage, type of anti-cancer treatment and highlight VTE rate in the UK and other countries.
Method: A systematic review was carried out and an electronic search for publications between January 2000 and November 2021 was done. Studies recording VTE in BC patients were included whilst paediatric patients, case reports, studies reporting on a mix of arterial and venous thrombosis, studies reporting DVT or PE only and recorded hospitalised VTE only were excluded. The rate of VTE, country of origin, risk factors and thromboprophylaxis duration for VTE in BC patients were identified.
Results: A total of 38 papers meeting the search criteria. All publications were original research papers (cohort studies). The overall VTE rate in patients with BC was estimated at 1.9 to 4.7%. For those patients undergoing cystectomy, VTE rate ranged from 3% to 17.6%; however, VTE rate in metastatic stage of BC patients ranged from 3.1% to 5.1%.
Conclusions: Rates of VTE in BC patients are high, further increased by interventions such as surgery and chemotherapy. Thromboprophylaxis measures should be optimised. This review highlighted the fact that VTE rate in BC varies between studies due to the heterogeneity of risk factors reported.