Venous thromboembolism in cancer patients: expanding horizons.
Venous thromboembolism (VTE) and particularly idiopathic VTE may be paraneoplastic phenomena. The merits of screening patients with idiopathic VTE for occult cancer are still under debate, and randomized studies are required to establish its potential cost-effectiveness. Cancer and its related surgery greatly increase the risk of VTE. Thromboprophylaxis using agents such as low-molecular-weight heparin (LMWH) has proved to be safe and effective in reducing the incidence of postoperative VTE. The ENOXACAN II study has shown that prolonging the standard 1-week regimen of the LMWH enoxaparin to 4 weeks may further reduce the incidence of postoperative VTE. Enoxaparin has also shown potential benefits in the secondary prevention of VTE and the reduction of bleeding complications. Emerging data indicate that LMWH may improve survival rates in cancer patients with VTE, making this a very important area for future research.
Bergqvist
David
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Department of Surgery, Akademiska Sjukhuset, Uppsala University, 75185 Uppsala, Sweden. david.bergqvist@kirugi.uu.se
D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D004311:Double-Blind Method; D017984:Enoxaparin / Q000627:therapeutic use; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D015201:Meta-Analysis as Topic; D015337:Multicenter Studies as Topic; D009369:Neoplasms / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D010257:Paraneoplastic Syndromes / Q000188:drug therapy / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D013923:Thromboembolism / Q000188:drug therapy / Q000517:prevention & control*; D019851:Thrombophilia / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000188:drug therapy / Q000517:prevention & control*; D014859:Warfarin / Q000627:therapeutic use
D000970:Antineoplastic Agents; D017984:Enoxaparin; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin