Thromboprophylaxis in the Cancer Patient

Conclusions

Thrombosis is an important complication in cancer patients. Cancer surgical patients receiving thromboprophylaxis with either low-dose or low molecular weight heparin are protected against thrombosis, this intervention has been validated in terms of efficacy and safety. In non-surgical cancer patients, those with breast cancer may receive low-dose oral anticoagulation with vitamin K antagonists. The benefit of routine thromboprophylaxis in other ambulant cancer populations receiving medical therapy for their cancers remains to be established by way of prospective clinical trials. For cancer patients with central venous catheters, no recommendations can be made about routine antithrombotic therapy, although certain patients at high risk could be considered for either vitamin K antagonists (Warfarin, 1mg) or low molecular weight heparin (Dalteparin, 2500 units). The intriguing observation that low molecular weight heparin therapy may be associated with enhanced survival has become more plausible with the evidence generated from contemporary prospective clinical trials.However, further clinical trials in specific cancer populations are required before low molecular weight heparins may be used for this exciting indication.