Venous Thromboembolism in Cancer Patients Undergoing Chemotherapy: Risk Factors and Prevention

Prandoni, Paolo; Campello, Elena

doi:10.1055/s-0040-1718927

Cited by 8 publications

(9 citation statements)

References 44 publications

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“…Current evidence supported that four prothrombotic pathway consist of activation of extrinsic and intrinsic coagulation pathway, platelet activation and impair fibrinolysis. 26 Even though cancer may be considered in neoadjuvant setting and therefore may be amenable to surgical excision, certain tumor types with high thrombogenic potential such as gastric or pancreatic cancers could activate blood coagulation, leading to thrombosis. 27,28 Furthermore, neoadjuvant chemotherapy increases the risk of VTE by directly damaging the endothelium, reducing blood anticoagulant levels, increasing procoagulant factor, stimulating platelet activation and increasing tissue factor activity.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors for Venous Thromboembolism Following 2462 Major Abdomino-Pelvic Surgeries in Tertiary Hospital

Taengsakul

Saiwongse

Sakornwattananon

et al. 2021

VHRM

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Purpose To determine the incidence and risk factor of postoperative venous thromboembolism (VTE) in Thai populations and to evaluate morbidity, mortality, bleeding complications and the benefit of thromboprophylaxis in real-world practice. Patients and Methods We performed a retrospective, single-center, cohort study of patients from all age groups who underwent elective open or laparoscopic major abdomino-pelvic surgery between January 2008 and December 2018 at Chulabhorn Hospital, Bangkok, Thailand. We collected general medical information and specific data based on items from the Caprini risk scoring system. Results A total of 2462 major abdomino-pelvic surgeries were included. The study population consisted of 742 males (30.1%) and 1720 females (69.9%) aged 54.59 ± 13.27 years. The incidence of VTE in Thai patients that underwent major abdominal surgery was 0.48%. The most frequent influencing factor for VTE was a history of pulmonary embolism, which increased the risk of VTE 98.28-fold, whereas a history of deep vein thrombosis increased the risk of VTE by 12.34-fold. Other factors influencing VTE development were obesity, anticoagulant use, postoperative chemotherapy, preoperative chemotherapy, endometrium cancer, tumor-node-metastasis (TNM) stage 4 and American College of Chest Physicians (ACCP) class 4. Protective factors included no history of VTE, laparoscopic surgery, TNM stage 0 and benign disease and BMI<30. VTE significantly increased mortality whereas following ACCP guideline reduced mortality. Conclusion Post-operative VTE incidence in Thai patients undergoing major abdomino-pelvic surgery was lower compared with Western patients. Factors influencing for VTE were history of VTE, anticoagulant use, postoperative chemotherapy, preoperative chemotherapy, endometrium cancer, TNM stage 4 and ACCP class 4. Following ACCP guideline reduced the incidence of mortality.

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Section: Discussionmentioning

confidence: 99%

Incidence and Risk Factors for Venous Thromboembolism Following 2462 Major Abdomino-Pelvic Surgeries in Tertiary Hospital

Taengsakul

Saiwongse

Sakornwattananon

et al. 2021

VHRM

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“…Low-dose DOACs have the potential to offer a protection against VTE complications, obviating the burden and the cost of LMWH. 70…”

Section: Primary Prevention In Hereditary Thrombophiliamentioning

confidence: 99%

Evolving Knowledge on Primary and Secondary Prevention of Venous Thromboembolism in Carriers of Hereditary Thrombophilia: A Narrative Review

Campello

Prandoni²

2022

Semin Thromb Hemost

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The association between heritability of venous thromboembolism (VTE) and thrombophilia was first reported clinically in 1956, later followed by the first description of a congenital cause of hypercoagulability—antithrombin deficiency—in 1965. Since then, our knowledge of hereditary causes of hypercoagulability, which may predispose carriers to VTE has improved greatly. Novel genetic defects responsible for severe thrombophilia have been recently identified and we have learned that a wide range of interactions between thrombophilia and other genetic and acquired risk factors are important determinants of the overall individual risk of developing VTE. Furthermore, therapeutic strategies in thrombophilic patients have benefited significantly from the introduction of direct oral anticoagulants. The present review is an overview of the current knowledge on the mechanisms underlying inherited thrombophilia, with a particular focus on the latest achievements in anticoagulation protocols and prevention strategies for thrombosis in carriers of this prothrombotic condition.

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“…Patients with cancer are in a hypercoagulable state and venous thromboembolism (VTE) may be the first sign of malignancy 1,2 . In fact, approximately 20% of all VTE are observed in patients with cancer 3,4 .…”

Section: Introductionmentioning

confidence: 99%

“…

Patients with cancer are in a hypercoagulable state and venous thromboembolism (VTE) may be the first sign of malignancy. 1,2 In fact, approximately 20% of all VTE are observed in patients with cancer. 3,4 A large study in the general population from Denmark recently demonstrated that the cumulative incidence of VTE 12 months after cancer diagnosis was nearly ninefold higher than in subjects without cancer (2.3% vs 0.3%).

…”

mentioning

confidence: 99%

Haemostatic alterations in patients with cirrhosis and hepatocellular carcinoma: laboratory evidence and clinical implications

Zanetto

Campello

Pelizzaro

et al. 2022

Liver International

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Venous thrombosis is a frequent complication in cancer and is associated with high morbidity and mortality. Hepatocellular carcinoma (HCC) is the most common primary liver cancer and a leading cause of cancer‐related death worldwide, and it is associated with preexisting cirrhosis in 90% of cases. Patients with cirrhosis acquire complex alterations in their haemostatic system that may predispose them to bleed or thrombotic complications. There is growing evidence that HCC may tilt the haemostatic equilibrium in cirrhosis towards hypercoagulability, thus increasing the risk of venous thrombosis. Previously described mechanisms of HCC‐driven thrombophilia include thrombocytosis and increased platelet activation/function, increased fibrinogen concentration/polymerization, enhanced thrombin generation, hypofibrinolysis, and release of tissue factor‐expressing microvesicles. Nevertheless, there are currently no specific guidelines on risk stratification and management of thromboprophylaxis in patients with cirrhosis and HCC. Our review endeavours to summarize the latest findings on epidemiology, risk factors and pathogenesis of non‐malignant venous thrombosis in patients with cirrhosis and HCC, and provide evidence in support of tailored management of thrombotic risk in these patients.

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Venous Thromboembolism in Cancer Patients Undergoing Chemotherapy: Risk Factors and Prevention

Cited by 8 publications

References 44 publications

Incidence and Risk Factors for Venous Thromboembolism Following 2462 Major Abdomino-Pelvic Surgeries in Tertiary Hospital

Incidence and Risk Factors for Venous Thromboembolism Following 2462 Major Abdomino-Pelvic Surgeries in Tertiary Hospital

Evolving Knowledge on Primary and Secondary Prevention of Venous Thromboembolism in Carriers of Hereditary Thrombophilia: A Narrative Review

Haemostatic alterations in patients with cirrhosis and hepatocellular carcinoma: laboratory evidence and clinical implications

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