title: Trousseau's syndrome: cancer-associated thrombosis.
abstract: Trousseau's syndrome (cancer-associated thrombosis) is the second leading cause of death in cancer patients, after death from cancer itself. The risk of a venous thromboembolism is 4- to 7-fold higher in patients with cancer than in those without cancer. The causes of this impaired coagulation are associated with general patient-related risk factors, and other factors that are specific to the particular cancer or treatment. It is important to assess the risk of thrombotic events in cancer patients and administer effective prophylaxis and treatment. Effective prophylaxis and treatment of venous thromboembolism reduces morbidity and mortality, and improves patients' quality of life. Low molecular weight heparin is the first-line treatment for venous thromboembolism, as an effective and safe means for prophylaxis and treatment, according to guidelines released by international scientific societies. Oral anticoagulation therapy with warfarin is preferable to no therapy. However, warfarin has low efficacy and is associated with high rates of recurrence. If low molecular weight heparin is unavailable, some guidelines recommend the use of vitamin K antagonists that have a target international normalized ratio in the range of 2-3, as acceptable alternatives. Novel oral anticoagulants that directly inhibit factor Xa or thrombin are promising for the prophylaxis of high-risk cancer patients and in the long-term treatment of venous thromboembolism. However, to date, there is insufficient evidence to support the use of these new anticoagulants.
authors.affiliation: Department of Respiratory Medicine, Japanese Red Cross Medical Center, Tokyo, Japan ikushima_soichiro@med.jrc.or.jp.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Ikushima
authors.affiliation: Department of Respiratory Medicine, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: Ryu
authors.initials: R
authors.lastname: Ono
authors.affiliation: Department of Respiratory Medicine, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Fukuda
authors.affiliation: Department of Respiratory Medicine, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Sakayori
authors.affiliation: Department of Respiratory Medicine, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Awano
authors.affiliation: Department of Respiratory Medicine, Japanese Red Cross Medical Center, Tokyo, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kondo
mesh_terms: D000284:Administration, Oral; D001741:Black or African American / Q000706:statistics & numerical data; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001213:Asian / Q000706:statistics & numerical data; D019468:Disease Management; D000077425:Fondaparinux; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D019934:International Normalized Ratio; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D011134:Polysaccharides / Q000627:therapeutic use; D015995:Prevalence; D011788:Quality of Life; D012008:Recurrence; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013927:Thrombosis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D014812:Vitamin K / Q000037:antagonists & inhibitors; D014859:Warfarin / Q000627:therapeutic use; D044465:White People / Q000706:statistics & numerical data
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D011134:Polysaccharides; D014812:Vitamin K; D014859:Warfarin; D000077425:Fondaparinux
keywords: Trousseau's syndrome; arterial thrombosis; cancer-associated thrombosis; pulmonary embolism; venous thromboembolism