Abstract
Patients with cancer are at increased risk for venous thromboembolism (VTE). Prolonged
medical hospitalization, extensive surgeries, central venous catheters (CVCs), and
prothrombotic chemotherapeutic agents are important risk factors in cancer patients.
Recent efforts to improve VTE management in cancer patients are directed toward optimizing
prevention during high-risk periods. Prophylaxis with anticoagulants during hospitalizations
and the immediate postoperative period is well established, and although extended
postoperative prophylaxis for up to 4 weeks is safe, questions remain regarding benefit.
Thromboprophylaxis for preventing CVC-related thrombosis is no longer recommended.
Research is focusing on using validated risk-assessment models to identify high-risk
ambulatory patients who might benefit from thromboprophylaxis during chemotherapy.
Although the treatment of cancer-associated VTE is firmly based on the use of low-molecular-weight
heparin, questions remain regarding duration of therapy, management of catheter-related
thrombosis, use of inferior vena cava filters, and potential therapeutic roles of
the newer oral anticoagulants.
Keywords
cancer - venous thrombosis - prevention - treatment
