Diagnostic and prognostic importance of venous thromboembolism in ovarian cancer

Abstract

Background: Cancer and its chemotherapy are well known risk factors for venous thromboembolism. The later can be the first sign of an occult malignancy, especially if it is recurrent one. Venous thromboembolism is also a common cause of morbidity and mortality among cancer patients. In time of the first presentation of venous thromboembolism in the context of underlying cancer the advanced stage of cancer is usually present and this is associated with poor prognosis. Ovarian cancer which is diagnosed within four months after an episode of venous thromboembolism is usually in advanced stages with more aggressive biological properties. Conclusions: Low-molecular-weight-heparins are the cornerstone of treatment and prophylaxis of venous thromboembolism associated with cancer for the first 3 to 6 months after acute venous thromboembolic event. In accordance with current consensus they are replaced with oral anticoagulants after 6 months of treatment. According to recent trials lowmolecular- weight-heparins cause less side effects and there are less recurrent venous throm boembolisms than with peroral anticoagulant therapy. Accordingly their impact on improved survival of cancer patients is under intensive research. Unfortunately, there is currently no screening test for ovarian cancer which would lead to improved survival.