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Annals of Surgical Oncology

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01-12-2008 | Other

Venous Thromboembolism in Cancer Patients Undergoing Major Surgery

Authors: Nicolas H. Osborne, MD, Thomas W. Wakefield, MD, Peter K. Henke, MD

Published in: Annals of Surgical Oncology | Issue 12/2008

Abstract

Background

Cancer patients undergoing major abdominal or pelvic surgery are at considerable risk of venous thromboembolism (VTE). The genesis of thromboses in malignancy is complicated, and reflects the interaction and derangement of multiple molecular pathways. Furthermore, the nature and location of the cancer, as well as the type surgery involved, are thought to affect the level of VTE risk. These considerations may therefore affect treatment decisions.

Methods

We performed multiple Medline searches with terms including but not limited to VTE, cancer, surgery, abdominal, colorectal, unfractionated heparin (UFH), and low-molecular-weight heparin (LMWH) to identify reviews, meta-analyses, nonrandomized and randomized controlled trials, and clinical guidelines relating to management of VTE in patients with abdominal cancer.

Results

VTE incidence in patients with malignancy varied according to cancer type, location, stage of progression, and the use of catheters and/or chemotherapy. Thromboprophylaxis with UFH or LMWH reduces the risk of developing VTE in these patients. However, LMWHs have a favorable risk-benefit profile over UFH and extending the duration prophylaxis may improve outcomes.

Conclusion

A number of recommendations can be made for the prevention of VTE in patients undergoing abdominal or pelvic surgery for cancer: (1) risk-stratify all patients according to defined evidence-based guidelines; (2) for most abdominal surgical oncology patients at risk, use of both an anticoagulant and mechanical means are indicated and beneficial; and (3) consider extended-duration prophylaxis (up to 28 days) in those patients with major abdominal/pelvic operations and impaired mobility, preferably with LMWH.

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Title: Venous Thromboembolism in Cancer Patients Undergoing Major Surgery
Authors: Nicolas H. Osborne, MD
Thomas W. Wakefield, MD
Peter K. Henke, MD
Publication date: 01-12-2008
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 12/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-008-0151-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Venous Thromboembolism in Cancer Patients Undergoing Major Surgery

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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