title: Gender Differences in Cancer-associated Venous Thromboembolism.
abstract: Venous thromboembolism (VTE) is a commonly diagnosed multifactorial condition with significant morbidity and mortality, occurring in up to 20% of cancer patients. Indeed, patients with cancer are in a higher pro-thrombotic state due to alterations in their haemostatic- coagulative system, stasis and blood flow slowdown, endothelial dysfunction, vascular inflammation and platelet activation. Moreover, several cancer-dependent factors can sum up to trigger a first episode of VTE or to cause its recurrence in the course of anticoagulant treatment. Such a pro-thrombotic condition is further worsened by additional favoring risks such as immobilization, infection, surgery, or insertion of a central venous catheter, and anti-cancer therapy. Furthermore, in the secondary prevention setting, the anticoagulant therapy is accompanied by a high incidence of bleeding complications. Given the above, understanding and identifying the factors associated with the incidence and clinical outcome of VTE in cancer patients might be of great value in the prevention and management of VTEattributable complications, including death. Differences associated to gender on cancerrelated VTEs are not yet fully defined; many of the studies that addressed the question have been biased by erroneous/non homogeneous inclusion criteria. In the present review, we analyzed the potential differences in VTEs occurrence in cancer patients, by reporting the most significant findings in the recent literature. The identification of a differential clinical approach according to patient sex, might prompt the design of personalized treatment options tailored and optimized according to algorithms for oncological VTE prevention.
authors.affiliation: Department of Systems Medicine, Medical Oncology, Tor Vergata Clinical Center, Tor Vergata University of Rome. Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Riondino
authors.affiliation: Interinstitutional Multidisciplinary Biobank (BioBIM), IRCCS San Raffaele Pisana, Rome. Italy.
authors.forename: Fiorella
authors.initials: F
authors.lastname: Guadagni
authors.affiliation: Department of Systems Medicine, Medical Oncology, Tor Vergata Clinical Center, Tor Vergata University of Rome. Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Formica
authors.affiliation: Interinstitutional Multidisciplinary Biobank (BioBIM), IRCCS San Raffaele Pisana, Rome. Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Ferroni
authors.affiliation: Department of Systems Medicine, Faculty of Medicine, University of Rome Tor Vergata, Via di Montpellier 1, Rome. Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Roselli
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology*; D012307:Risk Factors; D012727:Sex Characteristics; D054556:Venous Thromboembolism / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000925:Anticoagulants
keywords: VTE occurrence; VTE recurrence; Venous thromboembolism; cancer; gender; thromboprophylaxis