title: [Cancer-associated venous thromboembolic recurrence: disregard of treatment recommendations].
abstract: Low-molecular-weight heparins (LMWH) are the reference curative treatment of venous thromboembolism (VTE) in patients with cancer. All international guidelines recommend the long-term use of LMWH given their demonstrated superiority compared to vitamin-K antagonists (VKA) in reducing VTE recurrence in this patient population without increased risk of bleeding. However, several studies consistently show a lack of adherence to treatment recommendations, which are applied at the very best in 50% of cases. This results in a loss of chance for patients with fragile prognosis and in whom VTE represents the second cause of death. Given the expected benefit and the increased VTE prevalence in patients with cancer, full awareness is necessary to implement programs aiming at improving the therapeutic management of cancer-associated VTE. This requires multidisciplinary consideration by qualified physicians involved in the management of patients with cancer-associated VTE such as oncologists, internists and those specialized in vascular disease and hemostasis.
authors.affiliation: Médecine interne, Hôpital Louis-Mourier, université Paris 7, EA REMES Université Paris Diderot, Sorbonne Paris Cité, APHP, 178, rue des Renouillers, 92700 Colombes, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Mahé
authors.affiliation: Médecine interne, Hôpital Louis-Mourier, université Paris 7, EA REMES Université Paris Diderot, Sorbonne Paris Cité, APHP, 178, rue des Renouillers, 92700 Colombes, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Chidiac
mesh_terms: D001291:Attitude of Health Personnel; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D038622:Internationality; D009369:Neoplasms / Q000150:complications*; D017410:Practice Guidelines as Topic; D055502:Secondary Prevention; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000517:prevention & control
chemical_list: D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight
keywords: anticoagulants; cancer; low-molecular-weight heparin; treatment guidelines; venous thromboembolism