PMID- 18841419
OWN - NLM
STAT- MEDLINE
DCOM- 20090226
LR  - 20081216
IS  - 1534-4681 (Electronic)
IS  - 1068-9265 (Linking)
VI  - 15
IP  - 12
DP  - 2008 Dec
TI  - Venous thromboembolism in cancer patients undergoing major surgery.
PG  - 3567-78
LID - 10.1245/s10434-008-0151-4 [doi]
AB  - BACKGROUND: Cancer patients undergoing major abdominal or pelvic surgery are at 
      considerable risk of venous thromboembolism (VTE). The genesis of thromboses in 
      malignancy is complicated, and reflects the interaction and derangement of 
      multiple molecular pathways. Furthermore, the nature and location of the cancer, 
      as well as the type surgery involved, are thought to affect the level of VTE 
      risk. These considerations may therefore affect treatment decisions. METHODS: We 
      performed multiple Medline searches with terms including but not limited to VTE, 
      cancer, surgery, abdominal, colorectal, unfractionated heparin (UFH), and 
      low-molecular-weight heparin (LMWH) to identify reviews, meta-analyses, 
      nonrandomized and randomized controlled trials, and clinical guidelines relating 
      to management of VTE in patients with abdominal cancer. RESULTS: VTE incidence in 
      patients with malignancy varied according to cancer type, location, stage of 
      progression, and the use of catheters and/or chemotherapy. Thromboprophylaxis 
      with UFH or LMWH reduces the risk of developing VTE in these patients. However, 
      LMWHs have a favorable risk-benefit profile over UFH and extending the duration 
      prophylaxis may improve outcomes. CONCLUSION: A number of recommendations can be 
      made for the prevention of VTE in patients undergoing abdominal or pelvic surgery 
      for cancer: (1) risk-stratify all patients according to defined evidence-based 
      guidelines; (2) for most abdominal surgical oncology patients at risk, use of 
      both an anticoagulant and mechanical means are indicated and beneficial; and (3) 
      consider extended-duration prophylaxis (up to 28 days) in those patients with 
      major abdominal/pelvic operations and impaired mobility, preferably with LMWH.
FAU - Osborne, Nicolas H
AU  - Osborne NH
AD  - Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann 
      Arbor, MI 48109, USA.
FAU - Wakefield, Thomas W
AU  - Wakefield TW
FAU - Henke, Peter K
AU  - Henke PK
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20081008
PL  - United States
TA  - Ann Surg Oncol
JT  - Annals of surgical oncology
JID - 9420840
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Humans
MH  - Meta-Analysis as Topic
MH  - Neoplasms/*complications
MH  - Practice Guidelines as Topic
MH  - Randomized Controlled Trials as Topic
MH  - Venous Thromboembolism/*etiology/prevention & control
RF  - 63
EDAT- 2008/10/09 09:00
MHDA- 2009/02/27 09:00
CRDT- 2008/10/09 09:00
PHST- 2008/06/16 00:00 [received]
PHST- 2008/08/19 00:00 [accepted]
PHST- 2008/08/18 00:00 [revised]
PHST- 2008/10/09 09:00 [entrez]
PHST- 2008/10/09 09:00 [pubmed]
PHST- 2009/02/27 09:00 [medline]
AID - 10.1245/s10434-008-0151-4 [doi]
PST - ppublish
SO  - Ann Surg Oncol. 2008 Dec;15(12):3567-78. doi: 10.1245/s10434-008-0151-4. Epub 
      2008 Oct 8.