Prevention of thromboembolic events after radical prostatectomy in patients with hereditary thrombophilia due to a factor V Leiden mutation by multidisciplinary coagulation management

Objective: To examine the perioperative impact of factor V Leiden mutation on thromboembolic events' risk in radical prostatectomy (RP) patients. With an incidence of about 5%, factor V Leiden mutation is the most common hereditary hypercoagulability among Caucasians and rarer in Asia. The incr...

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Main Authors: Randi M. Pose, Sophie Knipper, Jonas Ekrutt, Mara Kölker, Pierre Tennstedt, Hans Heinzer, Derya Tilki, Florian Langer, Markus Graefen
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Asian Journal of Urology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214388222000534
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author Randi M. Pose
Sophie Knipper
Jonas Ekrutt
Mara Kölker
Pierre Tennstedt
Hans Heinzer
Derya Tilki
Florian Langer
Markus Graefen
author_facet Randi M. Pose
Sophie Knipper
Jonas Ekrutt
Mara Kölker
Pierre Tennstedt
Hans Heinzer
Derya Tilki
Florian Langer
Markus Graefen
author_sort Randi M. Pose
collection DOAJ
description Objective: To examine the perioperative impact of factor V Leiden mutation on thromboembolic events' risk in radical prostatectomy (RP) patients. With an incidence of about 5%, factor V Leiden mutation is the most common hereditary hypercoagulability among Caucasians and rarer in Asia. The increased risk of thromboembolic events is three- to seven-fold in heterozygous and to 80-fold in homozygous patients. Methods: Within our prospectively collected database, we analysed 33 006 prostate cancer patients treated with RP between December 2001 and December 2020. Of those, patients with factor V Leiden mutation were identified. All patients received individualised recommendation of haemostaseologists for perioperative anticoagulation. Thromboembolic complications (deep vein thrombosis and pulmonary embolism) were assessed during hospital stay, as well as according to patient reported outcomes within the first 3 months after RP. Results: Overall, 85 (0.3%) patients with known factor V Leiden mutation were identified. Median age was 65 (interquartile range: 61–68) years. There was at least one thrombosis in 53 (62.4%) patients and 31 (36.5%) patients had at least one embolic event in their medical history before RP. Within all 85 patients with factor V Leiden mutation, we experienced no thromboembolic complications within the first 3 months after surgery. Conclusion: In our cohort of patients with factor V Leiden mutation, no thromboembolic events were observed after RP with an individualised perioperative coagulation management concept. This may reassure patients with this hereditary condition who are counselled for RP.
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spelling doaj-art-887f5dbeb65148c69d3cc6615ea86d8e2025-08-20T02:09:17ZengElsevierAsian Journal of Urology2214-38822024-01-01111424710.1016/j.ajur.2022.01.007Prevention of thromboembolic events after radical prostatectomy in patients with hereditary thrombophilia due to a factor V Leiden mutation by multidisciplinary coagulation managementRandi M. Pose0Sophie Knipper1Jonas Ekrutt2Mara Kölker3Pierre Tennstedt4Hans Heinzer5Derya Tilki6Florian Langer7Markus Graefen8Martini-Klinik Prostate Cancer Centre, University Hospital Hamburg-Eppendorf, Germany; Corresponding author.Martini-Klinik Prostate Cancer Centre, University Hospital Hamburg-Eppendorf, GermanyMartini-Klinik Prostate Cancer Centre, University Hospital Hamburg-Eppendorf, GermanyMartini-Klinik Prostate Cancer Centre, University Hospital Hamburg-Eppendorf, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, GermanyMartini-Klinik Prostate Cancer Centre, University Hospital Hamburg-Eppendorf, GermanyMartini-Klinik Prostate Cancer Centre, University Hospital Hamburg-Eppendorf, GermanyMartini-Klinik Prostate Cancer Centre, University Hospital Hamburg-Eppendorf, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, GermanyDepartment of Hematology and Oncology, University Medical Centre Hamburg-Eppendorf, Hamburg, GermanyMartini-Klinik Prostate Cancer Centre, University Hospital Hamburg-Eppendorf, GermanyObjective: To examine the perioperative impact of factor V Leiden mutation on thromboembolic events' risk in radical prostatectomy (RP) patients. With an incidence of about 5%, factor V Leiden mutation is the most common hereditary hypercoagulability among Caucasians and rarer in Asia. The increased risk of thromboembolic events is three- to seven-fold in heterozygous and to 80-fold in homozygous patients. Methods: Within our prospectively collected database, we analysed 33 006 prostate cancer patients treated with RP between December 2001 and December 2020. Of those, patients with factor V Leiden mutation were identified. All patients received individualised recommendation of haemostaseologists for perioperative anticoagulation. Thromboembolic complications (deep vein thrombosis and pulmonary embolism) were assessed during hospital stay, as well as according to patient reported outcomes within the first 3 months after RP. Results: Overall, 85 (0.3%) patients with known factor V Leiden mutation were identified. Median age was 65 (interquartile range: 61–68) years. There was at least one thrombosis in 53 (62.4%) patients and 31 (36.5%) patients had at least one embolic event in their medical history before RP. Within all 85 patients with factor V Leiden mutation, we experienced no thromboembolic complications within the first 3 months after surgery. Conclusion: In our cohort of patients with factor V Leiden mutation, no thromboembolic events were observed after RP with an individualised perioperative coagulation management concept. This may reassure patients with this hereditary condition who are counselled for RP.http://www.sciencedirect.com/science/article/pii/S2214388222000534Prostate cancerProstatectomyFactor V Leiden mutationThromboembolismThrombophilia
spellingShingle Randi M. Pose
Sophie Knipper
Jonas Ekrutt
Mara Kölker
Pierre Tennstedt
Hans Heinzer
Derya Tilki
Florian Langer
Markus Graefen
Prevention of thromboembolic events after radical prostatectomy in patients with hereditary thrombophilia due to a factor V Leiden mutation by multidisciplinary coagulation management
Asian Journal of Urology
Prostate cancer
Prostatectomy
Factor V Leiden mutation
Thromboembolism
Thrombophilia
title Prevention of thromboembolic events after radical prostatectomy in patients with hereditary thrombophilia due to a factor V Leiden mutation by multidisciplinary coagulation management
title_full Prevention of thromboembolic events after radical prostatectomy in patients with hereditary thrombophilia due to a factor V Leiden mutation by multidisciplinary coagulation management
title_fullStr Prevention of thromboembolic events after radical prostatectomy in patients with hereditary thrombophilia due to a factor V Leiden mutation by multidisciplinary coagulation management
title_full_unstemmed Prevention of thromboembolic events after radical prostatectomy in patients with hereditary thrombophilia due to a factor V Leiden mutation by multidisciplinary coagulation management
title_short Prevention of thromboembolic events after radical prostatectomy in patients with hereditary thrombophilia due to a factor V Leiden mutation by multidisciplinary coagulation management
title_sort prevention of thromboembolic events after radical prostatectomy in patients with hereditary thrombophilia due to a factor v leiden mutation by multidisciplinary coagulation management
topic Prostate cancer
Prostatectomy
Factor V Leiden mutation
Thromboembolism
Thrombophilia
url http://www.sciencedirect.com/science/article/pii/S2214388222000534
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