Cancer associated venous thromboembolism

Celi, Alessandro and Marconi, Letizia and Palla, Antonio (2015) Cancer associated venous thromboembolism. Shortness of Breath, 4 (2). pp. 35-41. ISSN 2281-6550

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Cancer represents a well recognized risk factor for venous thromboembolism. Patients with cancer have a 4-7 fold higher risk for venous thromboembolism than patients without the disease. Some sites of cancer (e.g. pancreas, stomach) are associated with a higher risk than others (e.g. breast, prostate); advanced stage is also associated with a higher risk. Finally, numerous chemotherapeutic agents contribute to the development of venous thromboembolism. Despite the high incidence of thromboembolism, routine primary prophylaxis is not recommended in most cancer patients. Scores that evaluate site, stage and concomitant risk factors are being evaluated but have not gained widespread acceptance to date. Screening patients with venous thromboembolism for occult cancers has shown little impact on survival and in general is not recommended. The pathogenesis of thrombosis in cancer patients, although extremely complex, involves the synthesis of proinflammatory mediators by the host that contributes to the activation of the coagulation cascade, as well as the synthesis of the procoagulant and proangiogenic factor, tissue factor, by the tumor. Patients with venous thromboembolism and active cancer are usually treated with low molecular weight heparin for 6 months; after that, there are no clear guidelines to suggest the best therapeutic approach. The new direct oral anticoagulants are currently not indicated in these patients; however, clinical studies are in progress to evaluate their promising role in this setting.

Item Type: Article
Uncontrolled Keywords: cancer, venous thromboembolism, vitamin K antagonists, low molecular weight heparin, direct oral anticoagulants, tissue factor.
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici)
Depositing User: Sig. Francesco Solfizi
Date Deposited: 19 Mar 2020 15:05
Last Modified: 19 Mar 2020 15:05

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