Cancer-associated thrombosis: A meta-analysis and single-center experience

Abstract

Objectives: In this study, we present our clinical experience in patients with cancer-associated venous thrombosis (CAT) and aimed to conduct a meta-analysis to compare direct-acting oral anticoagulants (DOACs) with each other and low-molecular-weight heparin (LMWH). Patients and methods: Between January 2010 and December 2020, a total of 98 patients (44 males, 54 females; mean age: 65.6±13.4 years; range, 21 to 91 years) diagnosed with both cancer and venous thromboembolism (VTE) were screened in the computer-based database system. Randomized-controlled trials and clinical trials conducted between 2016 and 2020, in which DOACs were compared with LMWH in the treatment of VTE in cancer patients, were screened using the MEDLINE database via PubMed and SCOPUS. Results: Gynecological and gastrointestinal tract cancers were the most common malignancies in 22.4% and 28.6% of the patients, respectively). The rate of deep venous thrombosis (DVT) was higher (65.4%) and five patients had upper extremity DVT. Direct-acting oral anticoagulants were found to be more effective than LMWH in preventing recurrent VTE (risk ratio [RR]: 0.111; 95% confidence interval [CI]: 0.014-0.866; p=0.036 vs. RR: 0.444; 95% CI: 0.198-0.999; p=0.036, respectively). Conclusion: Based on our clinical experience and meta-analysis results, DOACs can be considered a reasonable alternative in patients with CAT. Clinicians should keep in mind that treatment of CAT requires a multidisciplinary approach and interdisciplinary collaboration. [Turk J Vasc Surg 2022; 31(1.000): 44-52]

Keywords

• cancers
• direct-acting oral anticoagulants
• low-molecular-weight heparin
• venous thromboembolism