A survey of physician perception and practices regarding pharmacological thromboprophylaxis during chemotherapy for bladder cancer

Authors

  • Andrew Amenyogbe Division of Urology, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
  • Francis Lemire Division of Urology, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
  • David Yachnin The Ottawa Hospital Research Institute, Ottawa, ON, Canada
  • Marc Carrier Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
  • Kristen McAlpine Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
  • Rodney H. Breau Division of Urology, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
  • Dominick Bossé Division of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
  • Tzu-Fei Wang Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
  • Christopher Morash Division of Urology, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
  • Ilias Cagiannos Division of Urology, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
  • Luke T. Lavallée Division of Urology, Department of Surgery, University of Ottawa, Ottawa, ON, Canada

DOI:

https://doi.org/10.5489/cuaj.7865

Keywords:

venous thromboembolism, bladder cancer, cystectomy, chemotherapy

Abstract

Introduction: Patients with advanced bladder cancer receiving chemotherapy have a high risk of venous thromboembolism (VTE); however, we hypothesized these patients are not routinely offered thromboprophylaxis. The objective of this study was to characterize practice patterns and perceptions of Canadian urologic and medical oncologists, and to identify research needs regarding thromboprophylaxis for patients with bladder cancer.

Methods: An online survey was distributed to Canadian urologic and medical oncologists who manage advanced bladder cancer. The survey explored physician opinions regarding VTE rates, risk stratification scores, thromboprophylaxis use in different treatment settings, and interest in clinical trials.

Results: Seventy physicians were invited and 36 (51%) completed the survey, including 20 (56%) urologic oncologists and 16 (44%) medical oncologists. Most respondents (35; 97%) believed that exposure to platinum chemotherapy increases VTE risk. For patients receiving neoadjuvant chemotherapy, 34 (94%) respondents estimated the risk of VTE to be 10% or higher, yet 25 (69%) indicated they do not routinely recommend thromboprophylaxis. Physicians frequently (10; 40%) defer the decision to another physician, while eight (32%) believe there is not enough evidence to guide best management. Similar responses were obtained for metastatic patients. Almost all (94%) respondents were interested in participating in a thromboprophylaxis trial for patients with bladder cancer.

Conclusions: Patients with bladder cancer receiving chemotherapy in Canada are not routinely offered thromboprophylaxis. We found strong interest among Canadian oncologists to participate in clinical trials examining this topic.

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Published

2022-05-20

How to Cite

Amenyogbe, A., Lemire, F., Yachnin, D., Carrier, M., McAlpine, K., Breau, R. H., Bossé, D., Wang, T.-F., Morash, C., Cagiannos, I., & Lavallée, L. T. (2022). A survey of physician perception and practices regarding pharmacological thromboprophylaxis during chemotherapy for bladder cancer. Canadian Urological Association Journal, 16(10). https://doi.org/10.5489/cuaj.7865

Issue

Section

Original Research