Doppler sonography had been done for all patients with suspicious symptoms and signs of DVT by three calibrated instruments (Accuvix v10 A, Sony Corporation, Tokyo, Japan). The following data were recorded in researcher-designed checklist: demographic characteristics, medical history, site of tumor, pathology of cancers, and using Doppler sonography in diagnosis of DVT. Code of ethics was achieved and all patients’ information was kept confidential. In this manner, 30 subjects in surgery group and 14 in chemotherapy group were excluded. We excluded all patients who had been treated with both surgery and chemotherapy as well as those who had received anticoagulant or antiplatelet drugs prior to treatment modalities. The study was based on the recorded data in medical files of patients with cancer in the archives of three teaching hospitals. According to previous studies and with regard to maximum sample size for comparing two proportions, the sample size was calculated at 602 (301 subjects in each group). The patients were recruited to this study by a simple nonrandomized sampling from October 2006 through August 2007. This retrospective cross-sectional study was performed on 602 known cases of cancer who had been admitted in three major tertiary referral centers and teaching hospitals of Kerman City, Iran. Although more VTE cases are diagnosed nowadays by modern imaging techniques, surgical treatment or chemotherapy may also explain this growing trend ( 1). For instance, a study showed the DVT prevalence rate of 1% as well as doubled rate of pulmonary emboli in seven years ( 7). On the other hand, increasing prevalence of DVT in hospitalized patients with cancer is alarming. In addition, economic impact of DVT is considerable ( 1). Furthermore, sequels of a DVT event such as pulmonary emboli, bleeding, post-thrombotic syndrome, or pulmonary hypertension can affect the patients with DVT. DVT, which is most often a treatable condition, is the second leading cause of death in patients with malignancies and is associated with decreased survival rate. Malignancy is one of the most common and important acquired risk factors for DVT and patients with active malignancy have a fourfold to sevenfold higher incidence of symptomatic VTE than the general population has ( 5, 6). Moreover, this prothrombotic state may be further exacerbated by chemotherapy, hormone therapy, and surgery ( 2- 4). Each factor ultimately contributes to the alteration of normal blood flow, thereby increasing thrombus formation ( 1). The increased risk of deep venous thrombosis (DVT) in patients with cancer appears to be due to the effect of malignancy on each component of the Virchow triad, namely, venous stasis, blood components imbalance, and vessel wall damage. Venous thromboembolism (VTE) is common among patients with cancer, particularly in those receiving cancer treatments.
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