Approach to cancer-associated thrombosis: Challenging situations and knowledge gaps Review


Authors: Wang, T. F.; Billett, H. H.; Connors, J. M.; Soff, G. A.
Review Title: Approach to cancer-associated thrombosis: Challenging situations and knowledge gaps
Abstract: Malignancy is a significant risk factor for venous thromboembolism (VTE). It is estimated that up to 20% of patients with cancer may develop VTE at some time in their cancer journey. Cancer-associated VTE can lead to hospitalizations, morbidity, delayed cancer treatment, and mortality. The optimal prevention and management of cancer-associated thrombosis (CAT) is of utmost importance. Direct oral anticoagulants have been recommended as first-line therapy for VTE treatment in the general population and their efficacy has recently been demonstrated in the cancer population, leading to increased use. However, patients with cancer have unique challenges and comorbidities that can lead to increased risks and concerns with anticoagulation. Herein we will discuss commonly encountered challenges in patients with CAT, review available literature, and provide practice suggestions. Implications for Practice: This article aims to specifically address cancer-associated thrombosis issues for which there is limited or absent evidence to guide best practice, for circumstances that pose unique challenges for clinicians, and for directions when the literature is conflicting. It reviews pertinent data for each selected topic and provides guidance for patient management based on the best available evidence and experiences from the panel. © 2020 AlphaMed Press
Keywords: cancer surgery; mortality; gastrointestinal hemorrhage; prospective study; esophagitis; morbidity; anticoagulant therapy; cancer therapy; risk factor; risk assessment; prescription; hospitalization; systematic review; acetylsalicylic acid; cardiovascular disease; thrombosis; nephrostomy; heparin; gastrectomy; stomach cancer; malignancy; anticoagulation; leukocyte count; atrial fibrillation; coronary artery disease; brain hemorrhage; chronic kidney failure; enoxaparin; platelet count; venous thromboembolism; anticoagulant agent; apixaban; rivaroxaban; duodenum ulcer; drug interaction; randomized controlled trial (topic); nephrolithiasis; cytochrome p450 3a; percutaneous coronary intervention; dabigatran; antivitamin k; renal clearance; human; article; thrombin time; edoxaban; malignant neoplasm; gastric bypass surgery; cancer-associated thrombosis
Journal Title: The Oncologist
Volume: 26
Issue: 1
ISSN: 1083-7159
Publisher: Oxford University Press  
Date Published: 2021-01-01
Start Page: e17
End Page: e23
Language: English
DOI: 10.1002/onco.13570
PUBMED: 33275323
PROVIDER: scopus
PMCID: PMC7794202
DOI/URL:
Notes: Article -- Export Date: 1 February 2021 -- Source: Scopus
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  1. Gerald A Soff
    93 Soff