Assessment of venous thromboembolism in adult-type diffuse gliomas at a quaternary neuro-oncology center: a retrospective cross-sectional study and systematic review
Abstract
Venous thromboembolism (VTE) remains a clinically relevant and impactful complication in patients with adult-type diffuse gliomas, and its overall frequency and determinants remain poorly defined. We retrospectively examined 147 patients with gliomas treated at a Brazilian quaternary neuro-oncology center during 2018–2023 and performed a Preferred Reporting Items for Systematic Reviews and Meta-Analysis/Synthesis without Meta-Analysis–based systematic review of observational studies (incorporating eight cohorts; N = 7779) published since 2015. The patients’ median age at diagnosis was 55 (range 20–86) years. Glioblastoma was the predominant glioma type (n = 91, 61.9%), followed by astrocytoma (n = 32, 21.8%) and oligodendroglioma (n = 24, 16.3%). VTE events occurred in 5 (3.4%) patients, 4 (80%) with isocitrate dehydrogenase (IDH)–wild-type glioblastoma (5.6% incidence within this subgroup) and 1 (20%) with IDH-mutant astrocytoma; no thrombosis was identified in patients with oligodendrogliomas. All five events (three pulmonary thromboembolism [PTE] and two lower-limb deep-vein thrombosis [DVT]) events) occurred within 6 months of surgery, clustered in patients aged between 41 and 60 years and evenly distributed by sex. Cerebral venous thrombosis (CVT) was not observed. In the systematic review, the VTE incidence rate was 6.2%–31% in grade 4 gliomas and 1.4%–5.2% in grades 2 and 3. DVT comprised 60% of thromboembolic events; PTE, 35%; and CVT, 5%. Poor performance status, a…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 7,779 participants or records.
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