title: Inferior vena cava filters in patients with advanced-stage cancer.
abstract: BACKGROUND
  Cancer and its treatment are recognized risk factors for venous thromboembolism (VTE). Inferior vena cava (IVC) filters are utilized to provide mechanical thromboprophylaxis to prevent pulmonary embolism (PE) or to avoid bleeding from systemic anticoagulation.
  
  
  METHODS
  A retrospective analysis of 107 cancer patients who had IVC filters inserted and followed up at our institution was performed. All patients had active cancer; a majority (> 90%) had advanced-stage disease, whereas only five patients (5.8%) had stages I or II disease.
  
  
  RESULTS
  Eighty six patients (80.3%) had their IVC filter placed through a jugular approach. Filter insertion was not without complications; recurrent deep vein thrombosis (DVT) was reported in 10 (9.3%), PE in three (2.8%) and filter thrombosis in one patient. The value of IVC filter in patients with advanced stage disease was very limited: among 59 patients with stage IV disease for whom survival data was available, the median survival was only 1.31 months (0.92-2.20) with 23 patients (39.0%) surviving less than a month, and 40 (67.8%) surviving less than three months.
  
  
  CONCLUSIONS
  Systemic anticoagulation can be safely offered for the majority of cancer patients. When the risk of bleeding or PE is high, IVC filters can be utilized. However, the placement of such filters should take into consideration the stage of disease and life expectancy of such patients. Patients with advanced-stage disease may gain little benefit from IVC filter insertion.
authors.affiliation: Department of Radiology, King Hussein Cancer Center, Amman, Jordan.
authors.forename: Asem
authors.initials: A
authors.lastname: Mansour
authors.affiliation: Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan.
authors.forename: Yousef
authors.initials: Y
authors.lastname: Ismael
authors.affiliation: Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan. Electronic address: habdelrazeq@khcc.jo.
authors.forename: Hikmat
authors.initials: H
authors.lastname: Abdel-Razeq
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D016306:Vena Cava Filters; D054556:Venous Thromboembolism / Q000517:prevention & control / Q000628:therapy*; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*
keywords: Anticoagulation; Bleeding; Cancer; Inferior vena cava filter