Abstract
Thrombosis is a common complication in patients with malignancy and its occurrence
is heightened by therapeutic interventions such as operations or the use of chemotherapy.
The magnitude of the risk for venous thromboembolism (VTE) is well established for
cancer surgery where rates twice that for abdominal surgery in noncancer subjects
are described. The case for routine thromboprophylaxis in patients receiving chemotherapy
is less clear, and prospective studies investigating rates of thrombosis by tumor
type, stage of disease, and chemotherapeutic regimens are required. For thromboprophylaxis
in the surgical patient either low-dose heparin or low-molecular-weight (LMW) heparin
are effective and safe. For patients receiving chemotherapy in advanced breast cancer,
low-dose warfarin is effective. Interestingly, heparin therapy may prolong survival
in patients with malignant disease; the mechanism is unclear, and observations from
retrospective analysis need to be confirmed in prospective studies.
Keywords:
Thromboembolism - cancer - thrombosis prophylaxis - heparin - LMW heparin - warfarin
