{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T05:22:51Z","timestamp":1766812971461,"version":"3.48.0"},"reference-count":39,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023331","name":"Leo Pharma","doi-asserted-by":"crossref","award":["(IIS FASLN29162"],"award-info":[{"award-number":["(IIS FASLN29162"]}],"id":[{"id":"10.13039\/501100023331","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Objective: We investigated the relationship between venous thromboembolism (VTE) and pelvic and para-aortic lymphadenectomy (LND) within the first 90 days post gynaecological cancer surgery. Methods: A retrospective cohort analysis was conducted on 1021 patients who underwent gynaecological cancer surgery between 2006 and 2019. Univariate and multivariate analysis was performed to assess the effects of LND and lymph node (LN) metastasis on VTE occurrence within 90 days post-surgery. Results: A total of 41 patients developed VTE within 90 days post-surgery. Para-aortic LND was significantly associated with VTE (p &lt; 0.001), with the highest rates (14.6%) observed in patients who had &gt;10 para-aortic LN removed. In patients with pelvic LN metastasis, 10 (7.5%) developed VTE; patients with &gt;5 pelvic nodes positive for metastasis had an HR = 4.83 (95% CI: 0.99\u201313.9) after adjustment for age, duration of hospital stay, and surgical approach. The highest VTE rates (27.3%) occurred in patients with &gt;5 para-aortic LN positive for metastasis, HR = 3.79 (95% CI 1.44\u201314.23) after adjustment for age, duration of hospital stay, and surgical approach (p = 0.011). Conclusions: Para-aortic LND significantly increases VTE risk within the first 90 days post-surgery. The risk is further amplified in cases with metastatic LN and persists even after adjustment for other risk factors for VTE. While extended thromboprophylaxis is standard for all cancer patients, our findings suggest that para-aortic LND\u2014especially with nodal metastases\u2014may help identify those who would benefit most from a more tailored, risk-based prophylaxis approach.<\/jats:p>","DOI":"10.3390\/cancers18010040","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T16:19:26Z","timestamp":1766420366000},"page":"40","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Para-Aortic Lymph Node Dissection and Metastasis Increase the Rate of Postoperative VTE in Gynaecological Cancers"],"prefix":"10.3390","volume":"18","author":[{"given":"Elzahra","family":"Ibrahim","sequence":"first","affiliation":[{"name":"Division of Gynaecology Oncology, St. James\u2019s Hospital, D08 NHY1 Dublin, Ireland"},{"name":"Department of Obstetrics and Gynaecology, Trinity Centre for Health Sciences, St. James\u2019s Hospital, D08 NHY1 Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9260-3225","authenticated-orcid":false,"given":"Sharoon","family":"O\u2019Toole","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Trinity Centre for Health Sciences, St. James\u2019s Hospital, D08 NHY1 Dublin, Ireland"},{"name":"Trinity St. James\u2019s Cancer Institute, St. James\u2019s Hospital, D08 NHY1 Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7862-3230","authenticated-orcid":false,"given":"Lucy","family":"Norris","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Trinity Centre for Health Sciences, St. James\u2019s Hospital, D08 NHY1 Dublin, Ireland"},{"name":"Trinity St. James\u2019s Cancer Institute, St. James\u2019s Hospital, D08 NHY1 Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9598-8650","authenticated-orcid":false,"given":"Feras","family":"Abu Saadeh","sequence":"additional","affiliation":[{"name":"Division of Gynaecology Oncology, St. James\u2019s Hospital, D08 NHY1 Dublin, Ireland"},{"name":"Department of Obstetrics and Gynaecology, Trinity Centre for Health Sciences, St. James\u2019s Hospital, D08 NHY1 Dublin, Ireland"},{"name":"Trinity St. James\u2019s Cancer Institute, St. James\u2019s Hospital, D08 NHY1 Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.ejogrb.2013.06.004","article-title":"Venous thromboembolism in ovarian cancer: Incidence, risk factors and impact on survival","volume":"170","author":"Norris","year":"2013","journal-title":"Eur. 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