Kara Terry

“The thing that excites me most about my project and the work I am doing is that it has the possibility of shaping future clinical practices!”

Identifying the risk of blood clots after minimally invasive surgery to remove cancers of the female reproductive system: A pan-Canadian initiative

The risk of blood clots in women with cancer of their reproductive organs (gynecological cancer) after they undergo major surgery in their abdomen or pelvis is well-established. Because of the known incidence and potentially fatal effects of blood clots in these women, they take preventative medication to stop these blood clots before they happen.

However, the benefit of this preventative medication in patients with gynecological cancer undergoing minimally invasive surgery is controversial. The incidence of blood clots in these patients is estimated to be below two per cent. The current use is based on certain risk criteria, such as lack of motility, obesity, history of blood clots and others, but these are present in a majority of patients with gynecological cancer and do not reflect the low incidence of blood clots. These risk factors have been extrapolated from colorectal cancer but, to date, no studies have explored risk factors for the development of blood clots in minimally invasive surgery for gynecological cancers.

We hope to develop a risk score to determine who will benefit most from preventative medication. We hypothesize that, although the absolute risk for blood clots in these women is low, the relative risk for certain subsets of patients may be high and these women would benefit from this medication.

This will be done through an analysis of patient data across Canada from 2014-2020 who have undergone minimally invasive surgery for gynecological cancers. The primary outcome we are measuring is the incidence of a blood clot 90 days after surgery, with secondary outcomes of potential risk factors.

These risk factors will not be able to be assessed in smaller scale studies, due to the rare incidence of blood clots, and we need a large, multi-centre study such as this one. This study will help identify women at greatest risk of blood clots to offer early intervention and ensure only women who will benefit from the therapy are exposed to its potential side effects.

Kara Terry was supervised by Christa Aubrey and her summer studentship was funded by the Alberta Women’s Health Foundation. She graduated from the Bachelor of Science with Specialization in Pharmacology program.