Incidence of symptomatic venous thromboembolism in oncological oral and maxillofacial operations: retrospective analysis

Lodders, Johannes N.; Parmar, S.; Stienen, Niki L.M.; Martin, Tom; Karagozoglu, K.H.; Heymans, Martijn W.; Forouzanfar, Tymour

doi:10.1016/j.bjoms.2014.12.001

Cited by 23 publications

(21 citation statements)

References 23 publications

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“…5,10,[12][13][14][15] Studies relying primarily on LMWH had similar VTE rates from 0.5% to 2.3%. 8,11 Rates of VTE ranged from 0% up to 14.0% in patients who did not receive any post-operative anticoagulation. 5,9,10,12 Seven studies reported outcomes regarding haematoma or bleeding complications following anticoagulation.…”

Section: Resultsmentioning

confidence: 99%

Rationalizing post‐operative prophylactic anticoagulation in reconstructive head and neck cancer patients: a review

Cevik

Middleton

Ramakrishnan

et al. 2021

ANZ Journal of Surgery

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Microsurgical reconstructive head and neck cancer patients are at high risk of venous thromboembolism. The use of anticoagulation can reduce their risk; however, this also increases their bleeding risk. It is not clear whether the benefits of treatment outweigh the risks, and whether a specific post-operative anticoagulation regime is superior. The aim of this review is to evaluate the evidence pertaining to the risks and benefits of post-operative anticoagulation and to provide a rationale for its use in head and neck cancer patients receiving free flaps. The secondary aim was to determine the optimal post-operative anticoagulation regimen. A search was conducted in the PubMed and EMBASE databases identifying studies reporting venous thromboembolism rates in reconstructive head and neck cancer patients undergoing free flaps. These studies were reviewed for their eligibility. Outcomes measured were rates of venous thromboembolism, bleeding-related and microsurgical complications. A total of 306 studies were found from the search with another seven studies identified from citations of key articles. After assessment, nine studies were included. Venous thromboembolism rates ranged from 0.5% to 7% and the rates of bleeding-related complications ranged from 2.4% up to 29%. Anticoagulation appears to lower the risk of venous thromboembolism in this patient group, but also increases the bleeding risk. Risk stratification using the Caprini risk assessment model can help surgeons make decisions. For patients with cancer, low molecular weight heparin appears to be superior to heparin given twice daily but equal to heparin given three times daily and the bleeding risk of each medication appears similar.

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Section: Resultsmentioning

confidence: 99%

Rationalizing post‐operative prophylactic anticoagulation in reconstructive head and neck cancer patients: a review

Cevik

Middleton

Ramakrishnan

et al. 2021

ANZ Journal of Surgery

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“…For OSCC patients and some head and neck cancer patients, recommendations for anticoagulation medication are unclear. Some authors propose a systematic anticoagulation therapy [40], whereas others limit this approach to patients with high risk of thrombosis due to other comorbidities [41]. These treatments are not without risk (hemorrhage and Thus, these findings suggest a deficiency of granule storage in mice with tongue tumors resulting in a lower activibility of platelets in bearing lingual tumor mice, independent of the agonist used.…”

Section: Discussionmentioning

confidence: 99%

Oral Squamous Cell Carcinoma Is Associated with a Low Thrombosis Risk Due to Storage Pool Deficiency in Platelets

et al. 2021

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Venous thrombo-embolism (VTE) disease is the second most common cause of mortality in cancer patients, and evaluation and prevention of thrombosis risk is essential. VTE-associated risk varies according to the type of tumor disease. Oral cancer is the most frequent type of head and neck cancer, and it represents approximately 2.1% of all cancers worldwide. Most tumors are squamous cell carcinomas and are mainly due to tobacco and alcohol abuse. VTE risk associated with oral squamous cell carcinoma (OSCC) is low. However, many studies have shown that OSCC has the following biological features of cancers associated with a high thrombosis risk: modified thrombosis and fibrinolysis mechanisms; strong expression of procoagulant proteins; secretion of procoagulant microparticles; and production of procoagulant cytokines. Using an original mouse model of tongue squamous cell carcinoma, our study aimed to clarify this paradoxical situation. First, we showed that OSCC tumors have a pro-aggregatory phenotype and a high local thrombosis risk. Second, we found that tongue tumor mice do not have an elevated systemic thrombosis risk (the risk of an “at distance” thrombosis event such as lower extremity deep venous thrombosis or pulmonary embolism) and even show a reduction in risk. Third, we demonstrated that tongue tumor mice show a reduction in platelet reactivity, which explains the low systemic thrombosis risk. Finally, we found that tongue tumor mice present granule pool deficiency, thereby explaining the reduction in platelet reactivity and systemic thrombosis risk.

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“…However, not only cancer surgery in the abdominal, pelvic and thoracic areas is linked to the risk of thrombosis. Reports on the occurrence of VTE episodes also concern cancer surgery procedures in the neck and head region, including maxillofacial surgery or commonly performed surgical procedures for breast cancer [49][50][51][52][53][54]. The risk of symptomatic VTE in the population of patients after breast cancer surgery ranges from 0.12-0.5 [52][53][54].…”

Section: Recommendation 28mentioning

confidence: 99%

Wytyczne leczenia i profilaktyki żylnej choroby zatorowo-zakrzepowej u chorych onkologicznych leczonych operacyjnie z uwzględnieniem chorych poniżej 18. roku życia

Krasiński¹,

Urbanek²,

Undas³

et al. 2021

Acta Angiologica

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Incidence of symptomatic venous thromboembolism in oncological oral and maxillofacial operations: retrospective analysis

Cited by 23 publications

References 23 publications

Rationalizing post‐operative prophylactic anticoagulation in reconstructive head and neck cancer patients: a review

Rationalizing post‐operative prophylactic anticoagulation in reconstructive head and neck cancer patients: a review

Oral Squamous Cell Carcinoma Is Associated with a Low Thrombosis Risk Due to Storage Pool Deficiency in Platelets

Wytyczne leczenia i profilaktyki żylnej choroby zatorowo-zakrzepowej u chorych onkologicznych leczonych operacyjnie z uwzględnieniem chorych poniżej 18. roku życia

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