[Venous thromboembolism and cancer].
OBJECTIVE
The risk of venous thrombosis during cancer is largely increased especially in case of chemotherapy, surgery, advanced stage disease, coagulation abnormalities. Survival of patients with cancer experiencing venous thrombosis seems to be worse. Although thrombosis may be a presenting feature of occult malignancy, there are insufficient data to support a more extensive screening than comprehensive medical history, physical examination, routine laboratory tests and chest radiography.


BACKGROUND
Pathophysiology of venous thrombosis during cancer is unspecific: venous stasis, vessel wall damage, hypercoagulability). Other factors like platelet abnormalities or the direct responsibility of chemotherapy or hormonotherapy have recently been though to play a causative role. Treatment of cancer-associated thrombosis usually requires at least 6 months of low-molecular-weight heparin therapy rather than oral anticoagulant. Inferior vena cava filters are not indicated. Primary prophylaxis of thrombosis during cancer could safely been achieved with low-molecular-weight heparin. Central venous catheters can be associated with thrombotic complications. Many risks factors have been identified: catheter's type, modalities of catheter's implantation, type of perfusion, bulky mediastinal mass... Prophylactic anticoagulation is not routinely recommended.


CONCLUSIONS
Knew oral anticoagulants could facilitate the treatment of venous thrombosis occurring during cancer in the next years.
Pavic
M
M
Service de Médecine Interne, Hôpital d'Instruction des Armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France. m.pavic@chello.fr
Debourdeau
P
P
Aletti
M
M
Farge-Bancel
D
D
Rousset
H
H
D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D001777:Blood Coagulation; D001791:Blood Platelet Disorders / Q000150:complications; D002405:Catheterization, Central Venous / Q000009:adverse effects; D005260:Female; D005544:Forecasting; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D011183:Postoperative Complications / Q000517:prevention & control; D011322:Primary Prevention; D011379:Prognosis; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D012307:Risk Factors; D013923:Thromboembolism / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D013997:Time Factors; D020246:Venous Thrombosis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight