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    Primary thromboprophylaxis for cancer patients with central venous catheters--a reappraisal of the evidence.

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    Authors
    Cunningham, M S
    White, B
    Hollywood, D
    O'Donnell, J
    Issue Date
    2006-01-30
    Keywords
    CANCER
    THROMBOEMBOLISM
    MeSH
    Anticoagulants
    Antineoplastic Agents
    Catheterization, Central Venous
    Catheters, Indwelling
    Clinical Trials as Topic
    Evidence-Based Medicine
    Humans
    Neoplasms
    Venous Thrombosis
    
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    Citation
    Primary thromboprophylaxis for cancer patients with central venous catheters--a reappraisal of the evidence. 2006, 94 (2):189-94 Br. J. Cancer
    Journal
    British journal of cancer
    URI
    http://hdl.handle.net/10147/621424
    DOI
    10.1038/sj.bjc.6602917
    PubMed ID
    16404436
    Additional Links
    www.bjcancer.com
    Abstract
    Venous thromboembolism (VTE) is responsible for an estimated 25 000 deaths per annum in UK hospital practice. It is well established that many of these deaths could be prevented through the use of appropriate thromboprophylaxis. This issue is of particular relevance in oncology practice, where the risks of VTE and bleeding are both significantly higher than those observed in general medical patients. Cancer patients with in-dwelling central venous catheters (CVCs) are at particularly high risk of developing thrombotic complications. However, the literature has produced conflicting conclusions regarding the efficacy of using routine primary thromboprophylaxis in these patients. Indeed such is the level of confusion around this topic, that the most recent version of the American College of Chest Physicians (ACCP) guidelines published in 2004 actually reversed their previous recommendation (published in 2001). Nevertheless, minidose warfarin continues to be routinely used in many oncology centres in the UK. In this article, we have performed a systematic review of the published literature regarding the efficacy and the risks, associated with using thromboprophylaxis (either minidose warfarin or low-dose LMWH) in cancer patients with CVC. On the basis of this evidence, we conclude that there is no proven role for using such thromboprophylaxis. However, asymptomatic CVC-related venous thrombosis remains common, and further more highly powered studies of better design are needed in order to define whether specific subgroups of cancer patients might benefit from receiving thromboprophylaxis.
    Item Type
    Article
    Language
    en
    ISSN
    0007-0920
    ae974a485f413a2113503eed53cd6c53
    10.1038/sj.bjc.6602917
    Scopus Count
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    St. Luke's Radiation Oncology Network, Dublin

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