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Research Article: Risk factor analysis and prediction of lower-extremity deep vein thrombosis after surgery in patients with non-small cell lung cancer

Date Published: 2026-07-30

Abstract:
Postoperative lower-extremity deep vein thrombosis (DVT) remains a clinically relevant complication after surgical resection for non-small cell lung cancer (NSCLC). This study aimed to identify factors associated with postoperative DVT and develop a nomogram for estimating DVT probability in patients undergoing NSCLC resection. This retrospective cohort study included 328 patients with histologically confirmed NSCLC who underwent curative-intent pulmonary resection between January 2021 and December 2025. All patients underwent preoperative and postoperative lower-extremity duplex ultrasonography. The primary outcome was newly detected lower-extremity DVT within 30 days after surgery. Univariable and multivariable logistic regression analyses were performed to evaluate variables associated with postoperative DVT. A nomogram was developed, and model performance was assessed using receiver operating characteristic (ROC) analysis, bootstrap internal validation, and calibration analysis. Among the included patients, 136 were assigned to the postoperative DVT group and 192 to the non-DVT group. Most DVT events were diagnosed during the index hospitalization and were asymptomatic, isolated distal DVT. In the primary multivariable model, age ?70 years (OR, 4.50; 95% CI, 1.21–17.85), diabetes mellitus (OR, 5.00; 95% CI, 1.16–22.55), adenocarcinoma histology (OR, 7.55; 95% CI, 1.80–30.44), and pathological stage III disease (OR, 5.16; 95% CI, 1.39–19.05) were independently associated with postoperative DVT. The nomogram showed an apparent area under the curve (AUC) of 0.896, with sensitivity of 86.15% and specificity of 91.25%. The bootstrap-corrected concordance index was 0.762, and the Hosmer–Lemeshow test showed no evidence of poor fit. Age, diabetes mellitus, adenocarcinoma histology, and pathological stage III disease were associated with postoperative DVT in patients with resected NSCLC. The nomogram might support postoperative DVT risk estimation, but further external validation is warranted.

Introduction:
Postoperative lower-extremity deep vein thrombosis (DVT) remains a clinically relevant complication after surgical resection for non-small cell lung cancer (NSCLC). This study aimed to identify factors associated with postoperative DVT and develop a nomogram for estimating DVT probability in patients undergoing NSCLC resection.

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