Risk Prediction and New Prophylaxis Strategies for Thromboembolism in Cancer.
Alice LabiancaTommaso BosettiAlice IndiniGiorgia NegriniRoberto Francesco LabiancaPublished in: Cancers (2020)
In the general population, the incidence of thromboembolic events is 117 cases/100,000 inhabitants/year, while in cancer patient incidence, it is four-fold higher, especially in patients who receive chemotherapy and who are affected by pancreatic, lung or gastric cancer. At the basis of venous thromboembolism (VTE) there is the so-called Virchow triad, but tumor cells can activate coagulation pathway by various direct and indirect mechanisms, and chemotherapy can contribute to VTE onset. For these reasons, several studies were conducted in order to assess efficacy and safety of the use of anticoagulant therapy in cancer patients, both in prophylaxis setting and in therapy setting. With this review, we aim to record principal findings and current guidelines about thromboprophylaxis in cancer patients, with particular attention to subjects with additional risk factors such as patients receiving chemotherapy or undergoing surgery, hospitalized patients for acute medical intercurrent event and patients with central venous catheters. Nonetheless we added a brief insight about acute and maintenance therapy of manifested venous thromboembolism in cancer patients.
Keyphrases
- venous thromboembolism
- risk factors
- direct oral anticoagulants
- papillary thyroid
- squamous cell
- liver failure
- locally advanced
- minimally invasive
- atrial fibrillation
- rectal cancer
- aortic dissection
- squamous cell carcinoma
- lymph node metastasis
- mesenchymal stem cells
- childhood cancer
- percutaneous coronary intervention
- acute coronary syndrome
- coronary artery disease
- coronary artery bypass
- clinical practice
- replacement therapy