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Semin Thromb Hemost 2006; 32(7): 694-699
DOI: 10.1055/s-2006-951297
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Cancer and Venous Thromboembolism

Andrea Piccioli1 , Anna Falanga2 , Ugo Baccaglini3 , Marina Marchetti2 , Paolo Prandoni1
  • 1Department of Medical and Surgical Sciences, University of Padua, Italy
  • 2Division of Hematology, Department of Hematology-Oncology, Ospedali Riuniti di Bergamo, Bergamo, Italy
  • 3Department of Day Surgery, University of Padua, Italy
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Publikationsdatum:
06. Oktober 2006 (online)

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ABSTRACT

The evidence of the important two-way clinical correlation between cancer and venous thromboembolism (VTE) dates back to Trousseau's time. Over time it has been established that cancer patients not only exhibit a higher risk of developing VTE when compared with noncancer patients, but also that VTE, especially in its idiopathic presentation, sometimes acts as an epiphenomenon of a hidden cancer, offering possible chances for anticipated diagnosis of the pathology. Research has contributed greatly to the progression of this field through the identification of VTE risk factors in this setting, and through the assessment of the most adequate thromboprophylaxis and treatment modalities as well as secondary prophylaxis management. Anticoagulant drugs appear to be an attractive strategy in cancer treatment because there is growing evidence for their possible benefits in terms of cancer prognosis and patient survival.

KEYWORDS

Cancer - venous thromboembolism - low molecular weight heparin - warfarin - hypercoagulability

REFERENCES

  • 1 Trousseau A. Phlegmasia alba dolens. In: Clinique Medical de l'Hotel Dieu de Paris. London; The New Sydenham Society 1865: 94-96
    Suche in Google Scholar
  • 2 Prandoni P, Falanga A, Piccioli A. Cancer and venous thromboembolism.  Lancet Oncol. 2005;  6 401-410
    CrossrefPubMedSuche in Google Scholar
  • 3 Falanga A, Barbui T, Rickles F R, Levine M N. Guidelines for clotting studies in cancer patients.  Thromb Haemost. 1993;  70 540-542
    PubMedSuche in Google Scholar
  • 4 Falanga A, Donati M B. Pathogenesis of thrombosis in patients with malignancy.  Int J Hematol. 2001;  73 137-144
    CrossrefPubMedSuche in Google Scholar
  • 5 Gale A J, Gordon S G. Update on tumor cell procoagulant factors.  Acta Haematol. 2001;  106 25-32
    CrossrefPubMedSuche in Google Scholar
  • 6 Otten H M, Prins M H. Venous thromboembolism and occult malignancy.  Thromb Res. 2001;  102 V187-V194
    CrossrefPubMedSuche in Google Scholar
  • 7 Blom J W, Doggen C J, Osanto S, Rosendaal F R. Malignancies, prothrombotic mutations, and the risk of venous thrombosis.  JAMA. 2005;  293 715-722
    CrossrefPubMedSuche in Google Scholar
  • 8 Piccioli A, Prandoni P, Ewenstein B M, Goldhaber S Z. Cancer and venous thromboembolism.  Am Heart J. 1996;  132 850-855
    CrossrefPubMedSuche in Google Scholar
  • 9 Shen V S, Pollak E W. Fatal pulmonary embolism in cancer patients: is heparin prophylaxis justified?.  South Med J. 1980;  73 841-843
    PubMedSuche in Google Scholar
  • 10 Prandoni P, Piccioli A, Girolami A. Cancer and venous thromboembolism: an overview.  Haematologica. 1999;  84 437-445
    PubMedSuche in Google Scholar
  • 11 Huber O, Bounameaux H, Borst F, Rohner A. Postoperative pulmonary embolism after hospital discharge: an underestimated risk.  Arch Surg. 1992;  127 310-313
    CrossrefPubMedSuche in Google Scholar
  • 12 Bergqvist D, Agnelli G, Cohen A T et al.. Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer.  N Engl J Med. 2002;  346 975-980
    CrossrefPubMedSuche in Google Scholar
  • 13 Levine M N. Prevention of thrombotic disorders in cancer patients undergoing chemotherapy.  Thromb Haemost. 1997;  78 133-136
    PubMedSuche in Google Scholar
  • 14 Goodnough L T, Saito A, Manni A et al.. Increased incidence of thromboembolism in stage IV breast cancer patients treated with a five-drug chemotherapy regimen: a study of 159 patients.  Cancer. 1984;  54 1264-1268
    CrossrefPubMedSuche in Google Scholar
  • 15 Otten H MMB, Mathijssen J, ten Cate H et al.. Symptomatic venous thromboembolism in cancer patients treated with chemotherapy: an underestimated phenomenon.  Arch Intern Med. 2004;  164 190-194
    CrossrefPubMedSuche in Google Scholar
  • 16 Prichard K I, Paterson A H, Paul N A et al.. Increased thromboembolic complications with concurrent tamoxifen and chemotherapy in a randomized trial of adjuvant therapy for women with breast cancer.  J Clin Oncol. 1996;  14 2731-2737
    CrossrefPubMedSuche in Google Scholar
  • 17 Deitcher S R, Gemes M PV. The risk of venous thromboembolic disease associated with adjuvant hormone therapy for breast carcinoma.  Cancer. 2004;  101 439-449
    CrossrefPubMedSuche in Google Scholar
  • 18 Goldhaber S Z. Tamoxifen: preventing breast cancer and placing the risk of deep vein thrombosis in perspective.  Circulation. 2005;  111 539-541
    CrossrefPubMedSuche in Google Scholar
  • 19 Verso M, Agnelli G. Venous thromboembolism associated with long-term use of central venous catheters in cancer patients.  J Clin Oncol. 2003;  21 3665-3675
    CrossrefPubMedSuche in Google Scholar
  • 20 Bern M M, Lokich J J, Wallach S R et al.. Very low dose of warfarin can prevent thrombosis in central venous catheters: a prospective trial.  Ann Intern Med. 1990;  112 423-428
    CrossrefPubMedSuche in Google Scholar
  • 21 Monreal M, Alastrue A, Rull M et al.. Upper extremity deep vein thrombosis in cancer patients with venous access devices prophylaxis with a low molecular weight heparin (Fragmin).  Thromb Haemost. 1996;  75 251-253
    PubMedSuche in Google Scholar
  • 22 Levine M N, Lee A Y, Kakkar A K. From Trousseau to targeted therapy: new insights and innovations in thrombosis and cancer.  J Thromb Haemost. 2003;  1 1456-1463
    CrossrefPubMedSuche in Google Scholar
  • 23 Geerts W H, Pineo G F, Heith J A et al.. Prevention of venous thromboembolism: the seventh ACCP conference on antithrombotic and thrombolytic therapy.  Chest. 2004;  126 338S-400S
    CrossrefPubMedSuche in Google Scholar
  • 24 Bergqvist D, Burmark U S, Flordal P A et al.. Low molecular weight heparin started before surgery as prophylaxis against deep vein thrombosis: 2500 versus 5000 anti Xa IU in 2070 patients.  Br J Surg. 1995;  82 496-501
    CrossrefPubMedSuche in Google Scholar
  • 25 Enoxacan Study Group . Efficacy and safety of enoxaparin versus unfractionated heparin for prevention of deep vein thrombosis in elective cancer surgery: a double-blind randomized multicentre trial with venographic assessment.  Br J Surg. 1997;  84 1099-1103
    CrossrefPubMedSuche in Google Scholar
  • 26 Rasmussen M S, Jorgensen L N, Wille-Jorgensen J P et al.. Prolonged prophylaxis with low molecular weight heparin (Dalteparin) after major abdominal surgery: the FAME study. In: Programs and Abstracts of the XIX Congress of the International Society of Thrombosis and Haemostasis July 12-18, 2003 Birmingham, United Kingdom (abst);
    Suche in Google Scholar
  • 27 Nurmohamed M T, van Riel A M, Henkens C M et al.. Low molecular weight heparin and compression stockings in the prevention of venous thromboembolism in neurosurgery.  Thromb Haemost. 1996;  75 233-238
    PubMedSuche in Google Scholar
  • 28 Agnelli G, Piovella F, Buoncristiani P et al.. Enoxaparin plus compression stockings alone in the prevention of venous thromboembolism after elective neurosurgery.  N Engl J Med. 1998;  339 80-85
    CrossrefPubMedSuche in Google Scholar
  • 29 Levine M, Hirsh J, Gent M et al.. Double-blind randomized trial of very-low-dose warfarin for prevention of thromboembolism in stage IV breast cancer.  Lancet. 1994;  343 886-889
    CrossrefPubMedSuche in Google Scholar
  • 30 Büller H R, Agnelli G, Hull R D et al.. Antithrombotic therapy for venous thromboembolic disease: the seventh ACCP Conference on antithrombotic and thrombolytic therapy.  Chest. 2004;  126(suppl) 401S-428S
    CrossrefPubMedSuche in Google Scholar
  • 31 Prandoni P, Lensing A WA, Cogo A et al.. The long-term clinical coarse of acute deep vein thrombosis.  Ann Intern Med. 1996;  125 1-7
    CrossrefPubMedSuche in Google Scholar
  • 32 Heit J A, Mohr D N, Silverstein M D et al.. Predictors of recurrence after deep vein thrombosis and pulmonary embolism: a population-based cohort study.  Arch Intern Med. 2000;  160 761-768
    CrossrefPubMedSuche in Google Scholar
  • 33 Prandoni P, Lensing A WA, Piccioli A et al.. Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thromboembolism.  Blood. 2002;  100 3484-3488
    CrossrefPubMedSuche in Google Scholar
  • 34 Lee A Y, Levine M N, Baker R I et al.. Low-molecular-weight heparin versus a coumarin for the prevention of venous thromboembolism in patients with cancer.  N Engl J Med. 2003;  349 146-153
    CrossrefPubMedSuche in Google Scholar
  • 35 Meyer G, Marjanovic Z, Valcke J et al.. Comparison of low-molecular weight heparin and warfarin for the secondary prevention of venous thromboembolism in patients with cancer: a randomized controlled study.  Arch Intern Med. 2002;  162 1729-1735
    CrossrefPubMedSuche in Google Scholar
  • 36 Falanga A, Piccioli A. Effect of anticoagulant drugs in cancer.  Curr Opin Pulm Med. 2005;  11 403-407
    CrossrefPubMedSuche in Google Scholar
  • 37 Kakkar A K, Levine M N, Kadziola Z et al.. Low-molecular-weight heparin therapy with dalteparin and survival in advanced cancer: the Fragmin advanced malignancy outcome study.  J Clin Oncol. 2004;  22 1944-1948
    CrossrefPubMedSuche in Google Scholar
  • 38 Klerk C PW, Smorenburg S M, Otten H YM et al.. The effect of low-molecular-weight heparin on survival in patients with advanced malignancy.  J Clin Oncol. 2005;  23 2130-2135
    CrossrefPubMedSuche in Google Scholar
  • 39 Altinbas M, Coskun H S, Er O et al.. A randomized clinical trial of combination chemotherapy with and without low-molecular-weight heparin in small cell lung cancer.  J Thromb Haemost. 2004;  2 1266-1271
    CrossrefPubMedSuche in Google Scholar
  • 40 Sorensen H T, Mellemkjaer L, Steffensen H et al.. The risk of a diagnosis of cancer after primary deep venous thrombosis or pulmonary embolism.  N Engl J Med. 1998;  338 1169-1173
    CrossrefPubMedSuche in Google Scholar
  • 41 Baron J A, Gridley G, Weiderpass E et al.. Venous thromboembolism and cancer.  Lancet. 1998;  351 1077-1080
    CrossrefPubMedSuche in Google Scholar
  • 42 Murchison J T, Wylie L, Stockton D L. Excess risk of cancer in patients with primary venous thromboembolism: a national population-based cohort study.  Br J Cancer. 2004;  91 92-95
    CrossrefPubMedSuche in Google Scholar
  • 43 White R H, Chew H K, Zhou H et al.. Incidence of venous thromboembolism in the year before the diagnosis of cancer in 528,693 adults.  Arch Inter Med. 2005;  65 1782-1787
    PubMedSuche in Google Scholar
  • 44 Sorensen H T, Mellemkjare L, Olsen J H, Baron J A. Prognosis of cancers associated with venous thromboembolism.  N Engl J Med. 2000;  343 1846-1850
    CrossrefPubMedSuche in Google Scholar
  • 45 Monreal M, Lensing A WA, Prins M H et al.. Screening for occult cancer in patients with acute deep vein thrombosis or pulmonary embolism.  J Thromb Haemost. 2004;  2 876-881
    CrossrefPubMedSuche in Google Scholar
  • 46 Piccioli A, Lensing A WA, Prins M H et al.. Extensive screening for occult malignant disease in idiopathic venous thromboembolism.  J Thromb Haemost. 2004;  2 884-889
    CrossrefPubMedSuche in Google Scholar

Andrea PiccioliM.D. 

Department of Medical and Surgical Sciences, 2nd Chair of Internal Medicine, University of Padua

Via Ospedale Civile 105, 35128 Padua, Italy

eMail: andreapiccioli@libero.it