title: American Society of Clinical Oncology guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer.
abstract: OBJECTIVE
  To develop guideline recommendations for the use of anticoagulation in the prevention and treatment of venous thromboembolism (VTE) in patients with cancer.
  
  
  METHODS
  A comprehensive systematic review of the medical literature on the prevention and treatment of VTE in cancer patients was conducted and reviewed by a panel of content and methodology experts. Following discussion of the results, the panel drafted recommendations for the use of anticoagulation in patients with malignant disease.
  
  
  RESULTS
  The results of randomized controlled trials of primary and secondary VTE medical prophylaxis, surgical prophylaxis, VTE treatment, and the impact of anticoagulation on survival of patients with cancer were reviewed. Recommendations were developed on the prevention of VTE in hospitalized, ambulatory, and surgical cancer patients as well as patients with established VTE, and for use of anticoagulants in cancer patients without VTE to improve survival.
  
  
  CONCLUSIONS
  Recommendations of the American Society of Clinical Oncology VTE Guideline Panel include (1) all hospitalized cancer patients should be considered for VTE prophylaxis with anticoagulants in the absence of bleeding or other contraindications; (2) routine prophylaxis of ambulatory cancer patients with anticoagulation is not recommended, with the exception of patients receiving thalidomide or lenalidomide; (3) patients undergoing major surgery for malignant disease should be considered for pharmacologic thromboprophylaxis; (4) low molecular weight heparin represents the preferred agent for both the initial and continuing treatment of cancer patients with established VTE; and (5) the impact of anticoagulants on cancer patient survival requires additional study and cannot be recommended at present.
authors.affiliation: Duke University Medical Center, University of Rochester Medical Center, Rochester, USA.
authors.forename: Gary H
authors.initials: GH
authors.lastname: Lyman
authors.forename: Alok A
authors.initials: AA
authors.lastname: Khorana
authors.forename: Anna
authors.initials: A
authors.lastname: Falanga
authors.forename: Daniel
authors.initials: D
authors.lastname: Clarke-Pearson
authors.forename: Christopher
authors.initials: C
authors.lastname: Flowers
authors.forename: Mohammad
authors.initials: M
authors.lastname: Jahanzeb
authors.forename: Ajay
authors.initials: A
authors.lastname: Kakkar
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Kuderer
authors.forename: Mark N
authors.initials: MN
authors.lastname: Levine
authors.forename: Howard
authors.initials: H
authors.lastname: Liebman
authors.forename: David
authors.initials: D
authors.lastname: Mendelson
authors.forename: Gary
authors.initials: G
authors.lastname: Raskob
authors.forename: Mark R
authors.initials: MR
authors.lastname: Somerfield
authors.forename: Paul
authors.initials: P
authors.lastname: Thodiyil
authors.forename: David
authors.initials: D
authors.lastname: Trent
authors.forename: Charles W
authors.initials: CW
authors.lastname: Francis
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy*
chemical_list: D000925:Anticoagulants