Risk assessment models for cancer-associated venous thromboembolism

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Venous thromboembolism (VTE) is common in cancer patients, and is associated with significant morbidity and mortality. Several factors, including procoagulant agents secreted by tumor cells, immobilization, surgery, indwelling catheters, and systemic treatment (including chemotherapy), contribute to an increased risk of VTE in cancer patients. There is growing interest in instituting primary prophylaxis in high-risk patients to prevent incident (first-time) VTE events. The identification of patients at sufficiently high risk of VTE to warrant primary thromboprophylaxis is essential, as anticoagulation may be associated with a higher risk of bleeding. Current guidelines recommend the use of pharmacological thromboprophylaxis in postoperative and hospitalized cancer patients, as well as ambulatory cancer patients receiving thalidomide or lenalidomide in combination with high-dose dexamethasone or chemotherapy, in the absence of contraindications to anticoagulation. However, the majority of cancer patients are ambulatory, and currently primary thromboprophylaxis is not recommended for these patients, even those considered at very high risk. In this concise review, the authors discuss risk stratification models that have been specifically developed to identify cancer patients at high risk for VTE, and thus might be useful in future studies designed to determine the potential benefit of primary thromboprophylaxis.

Original languageEnglish (US)
Pages (from-to)3468-3476
Number of pages9
JournalCancer
Volume118
Issue number14
DOIs
StatePublished - Jul 15 2012

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Keywords

  • cancer
  • risk assessment models
  • risk stratification
  • thromboprophylaxis
  • venous thromboembolism

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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