PO-37 - Optimization of the anticoagulant therapy in cancer patients

Abstract

Thrombophilia is a serious risk factor for cancer patients. To determine the optimal mode of appointment of antithrombotic prophylaxis in perioperative period in cancer patients. The study involved 889 patients with gynecological cancer in the perioperative period. Group I - LMWH for 10days before surgery 0.3ml, cessation of therapy 24hours before surgery, then 0.3ml for 10days postoperatively - 213 patients Group II - LMWH 24hours before surgery, then 0.3ml for 10days in postoperative period - 212 Group III - LMWH 0.3ml for 10days postoperatively - 216 Group IV - unfractionated heparin 5000IU 3 times a day for 10days in the postoperative period - 248. Before surgery rate of subcompensated DIC was 18.5-50%. After surgery rate of subcompensated DIC has increased significantly to 52-75%. In group I, normal levels of DIC markers (TAT, PF4, F1+2) has been observed in 1-3 days. In group II normalization of DIC markers has been observed in 3-5 days. In group III DIC markers tended to normalize in 5-7 days. In group IV normalization of DIC markers has been detected only on the 7th day. D-dimer in some patients remained heightened for up to 10days. In addition, 28 patients (13.7%) formed extensive bruising in the painful injection. The proposed scheme prophylaxis: LMWH 10days before surgery and cancel 24hours prior to surgery, then 0.3ml for 10days in the postoperative period - virtually eliminates the risk of thrombosis and contributes normalization of DIC markers in 3days. This scheme could be recommended for all cancer patients as a minimum program.