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Abstract
Venous thromboembolism is a frequent and serious complication in patients with cancer. It is an independent prognostic factor of death in cancer patients and the second leading cause of death, but physicians often underestimate its importance, as well as the need for adequate prevention and treatment. Management of venous thromboembolism in patients with cancer requires the coordinated efforts of a wide range of clinicians, highlighting the importance of a multidisciplinary approach. However, a lack of consensus among various national and international clinical practice guidelines has contributed to knowledge and practice gaps among practitioners, and inconsistent approaches to venous thromboembolism. The 2013 international guidelines for thrombosis in cancer have sought to address these gaps by critically re-evaluating the evidence coming from clinical trials and synthesizing a number of guidelines documents. An individualized approach to prophylaxis is recommended for all patients.
Highlights
Venous thromboembolism (VTE)—including deep vein thrombosis (DVT), pulmonary embolism (PE), and central venous catheter (CVC)-related thrombosis (CRT)—is a frequent and serious complication in patients with cancer.[1]
Guidelines on VTE treatment and prevention for patients with cancer have been successively published by the Italian Association of Medical Oncology (2006),[40] the French National Cancer Institute (2008),[41,42] the US National Comprehensive Cancer Network (2010),[43] the European Society for Medical Oncology (2011),[44] the American College of Chest Physicians (ACCP) (2012),[45] and the American Society of Clinical Oncology (2013).[12,46]
For treatment of VTE recurrence under anticoagulation, three options are recommended: a switch from vitamin K agonists (VKA) to lowmolecular-weight heparin (LMWH) when treated with VKA; an increase in LMWH dose when treated with LMWH; and, in some patients, vena cava filter insertion.[2]
Summary
Venous thromboembolism (VTE)—including deep vein thrombosis (DVT), pulmonary embolism (PE), and central venous catheter (CVC)-related thrombosis (CRT)—is a frequent and serious complication in patients with cancer.[1]. VENOUS THROMBOEMBOLISM TREATMENT IN PATIENTS WITH CANCER: UNDER-USE OF MANAGEMENT GUIDELINES
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