title: Thromboembolism during neoadjuvant therapy for gastrointestinal cancer.
abstract: Thromboembolism a common, costly, and morbid complication that is also associated with decreased survival in cancer patients. The risk of thromboembolism in cancer patients is underappreciated. In addition to symptomatic deep venous thrombosis and pulmonary embolism, asymptomatic and arterial thromboembolic events are important consideration in ambulatory cancer patients receiving neoadjuvant chemoradiotherapy (nCRT). No specific randomized trial examining thromboprophylaxis (TP) during nCRT for gastrointestinal cancer has been performed, and none is accruing. Most guidelines currently recommend against TP in ambulatory cancer patients due to a lack of data rather than proof of harm or lack of efficacy. It is clear that robust data are urgently required, and that treatment with nCRT in patients with gastrointestinal malignancy is not an indication for routine pharmacological TP at the present time.
authors: Departments of *Cancer Surgery ‡Haematology, Peter MacCallum Cancer Centre †General Surgery and Gastroenterology Clinical Institute, Epworth Healthcare, Melbourne, VIC, Australia.
authors: Philip J
authors: PJ
authors: Smart
authors: Kate L
authors: KL
authors: Burbury
authors: A Craig
authors: AC
authors: Lynch
authors: John R
authors: JR
authors: Mackay
authors: Alexander G
authors: AG
authors: Heriot
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D059248:Chemoradiotherapy / Q000009:adverse effects*; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000628:therapy*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D017410:Practice Guidelines as Topic; D011655:Pulmonary Embolism / Q000209:etiology / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight