Marc Carrier1, Alon D Altman2, Normand Blais3, Artemis Diamantouros4, Deanna McLeod5, Uthaman Moodley6, Christine Nguyen7, Stephanie Young8, Frank Schwenter9. 1. Ottawa Hospital Research Institute, Ottawa Hospital - General Campus, 501 Smyth Road, Box 201a, Ottawa, Ontario, K1H 8L6, Canada. Electronic address: mcarrier@toh.on.ca. 2. University of Manitoba, CancerCare Manitoba, Health Sciences Center, 810 Sherbrooke St., Rs406, Winnipeg, Manitoba, R3A-1R9, Canada. Electronic address: alon.altman@cancercare.mb.ca. 3. Centre Hospitalier de l'Université de Montreal (CHUM), 1051, rue Sanguinet, Montreal, QC, H2X 0C1, Canada. Electronic address: n.blais@umontreal.ca. 4. Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Office: E 242, Toronto, ON, M4N 3M5, Canada. 5. Kaleidoscope Strategic, Inc., 146 Marion St., Toronto, Ontario, M6R 1E7, Canada. Electronic address: deanna@kstrategic.com. 6. University of Saskatchewan, Saskatchewan Cancer Agency, 108 Hospital Drive, Apt/Suite/Office 2615, Saskatoon, Saskatchewan, S7N 0W8, Canada. 7. Foothills Medical Centre, Anticoagulation management services Clinic and Intensive Care Unit, 1403 29 Street NW, Office: 4801, Calgary, Alberta, T2N 2T9, Canada. 8. Memorial University, 300 Prince Philip Drive, 1759F St. John's, Newfoundland and Labrador, A1B 3V6, Canada. 9. Department of Surgery, Centre Hospitalier de l'Université de Montreal (CHUM), Surgical Division, Montreal University, 850 rue Saint-Denis, Montreal, Quebec, H2X 0A9, Canada. Electronic address: frank.schwenter.chum@ssss.gouv.qc.ca.
Abstract
BACKGROUND: Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Certain abdominopelvic cancer surgeries are associated with a six to 14-fold increased risk of DVT versus surgeries for benign disease, and extended thromboprophylaxis using perioperative LMWHs may further reduce VTE rates over standard duration administration. This review assesses the value of extended low molecular weight heparin (LMWH) thromboprophylaxis as a recommended strategy after abdominopelvic cancer surgery. DATA SOURCES: Six eligible randomized controlled trials (RCTs), seven meta-analyses (MAs), and five non-randomized cohort studies were identified evaluating extended versus standard thromboprophylaxis following abdominopelvic cancer surgery. FINDINGS AND CONCLUSIONS: Available evidence showed significantly reduced rates of VTE for extended versus standard LMWH thromboprophylaxis following abdominopelvic cancer surgery, with some studies showing trends toward reduced rates of symptomatic VTE events. Many of these studies showed significantly reduced rates of proximal DVT and some showed trends toward reduced PE, suggesting potentially important clinical benefits.
BACKGROUND:Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Certain abdominopelvic cancer surgeries are associated with a six to 14-fold increased risk of DVT versus surgeries for benign disease, and extended thromboprophylaxis using perioperative LMWHs may further reduce VTE rates over standard duration administration. This review assesses the value of extended low molecular weight heparin (LMWH) thromboprophylaxis as a recommended strategy after abdominopelvic cancer surgery. DATA SOURCES: Six eligible randomized controlled trials (RCTs), seven meta-analyses (MAs), and five non-randomized cohort studies were identified evaluating extended versus standard thromboprophylaxis following abdominopelvic cancer surgery. FINDINGS AND CONCLUSIONS: Available evidence showed significantly reduced rates of VTE for extended versus standard LMWH thromboprophylaxis following abdominopelvic cancer surgery, with some studies showing trends toward reduced rates of symptomatic VTE events. Many of these studies showed significantly reduced rates of proximal DVT and some showed trends toward reduced PE, suggesting potentially important clinical benefits.
Authors: Lucy A Norris; Mark P Ward; Sharon A O'Toole; Zibi Marchocki; Nadia Ibrahim; Ali S Khashan; Feras Abu Saadeh; Noreen Gleeson Journal: Res Pract Thromb Haemost Date: 2020-05-28
Authors: Ana Sofia Ore; Matthew A Shear; Fong W Liu; John L Dalrymple; Christopher S Awtrey; Leslie Garrett; Hannah Stack-Dunnbier; Michele R Hacker; Katharine McKinley Esselen Journal: Int J Gynecol Cancer Date: 2019-11-25 Impact factor: 3.437