Thrombosis Knowledge Centre
Special Patient Groups
Patients with cancer
Why do cancer patients represent a special population with regard to the use of anticoagulants?
The risk of VTE, is high in patients with cancer, compared with non-oncological surgery. In oncological surgery, the risk of DVT is twice as high and the risk of fatal PE is three times higher. 15% of cancer patients present an episode of VTE at some point of their disease. In patients treated for VTE, patients with cancer have a 2- to 3-fold higher risk of recurrent thrombosis than patients without cancer.
Prandoni, et al. Blood 2002;100:3484-8
Geerts, WH et al. Chest 2004;126(3 Suppl):338S-400S
The use of VKA is complex in patients with cancer
- Frequent concomitant medications
- Poor nutrition
- Chemotherapy-induced thrombocytopenia
- Impaired liver function … causing unpredictable changes in the dose-response relationship of VKA
- Frequent invasive procedures requiring the discontinuation of anticoagulant treatment
- Frequent damage to the venous network, complicating blood collection and laboratory monitoring.
The risk of bleeding is high in patients with cancer
Cancer surgery with prophylactic doses of UFH is associated with an increased bleeding risk
Mismetti, et al. Br J Surg 2001;88:913-30
Long-term treatment of VTE with anticoagulants is associated with an increased risk of major bleeding
Prandoni, et al. Blood 2002;100:3484-8
Prandoni P. Blood 106:4027-33
Read International recommendations for VTE prophylaxis in cancer patients
Read International recommendations for VTE treatment in cancer patients