Prevalence of pulmonary embolism at necropsy in patients with cancer.

Svendsen, Einar; Karwinski, B.

doi:10.1136/jcp.42.8.805

Cited by 94 publications

(59 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A study of 21530 Swedish autopsies over a 24-year period showed the highest prevalence of pulmonary embolism was in patients with ovarian cancer, cancer of the extra-hepatic bile duct system and cancer of the stomach. 25 Similar figures emerged from an Italian autopsy study of 27 410 patients. 26 There are significant variations in VTE incidence according to the site of the cancer, whereas associations with disease extension are less convincing.…”

Section: Thromboprophylaxis In Cancer Patientssupporting

confidence: 69%

The heparins and cancer: review of clinical trials and biological properties

2004

View full text Add to dashboard Cite

Abstract:The association between cancer and thromboembolic disease is a well-known phenomenon and can contribute significantly to the morbidity and mortality of cancer patients. The spectrum of thromboembolic manifestations in cancer patients includes deep vein thrombosis, pulmonary embolism, but also intravascular disseminated coagulation and abnormalities in the clotting system in the absence of clinical manifestations. Unfractioned heparin (UFH) and particularly low molecular weight heparins (LMWHs) are widely used for the prevention and treatment of thromboembolic manifestations that commonly accompany malignancies. Malignant growth has also been linked to the activity of heparin-like glycosoaminoglycans, to neoangiogenesis, to protease activity, to immune function and gene expression. All these factors contribute in the proliferation and dissemination of malignancies. Heparins may play a role in tumour cell growth and in cancer dissemination. The aims of the study are to review the efficiency of heparins in the prevention and treatment of cancer-related thromboembolic complications, and review the biological effects of heparins. Heparins are effective in reducing the frequency of thromboembolic complications in cancer patients. Meta-analyses comparing unfractioned heparins and LMWHs for the treatment of deep vein thrombosis have shown better outcome with a reduction of major bleeding complications in patients treated with LMWHs. LMWH have antitumour effects in animal models of malignancy: heparin oligosaccharides containing less than 10 saccharide residues have been found to inhibit the biological activity of basic fibroblast growth factor (bFGF), whereas heparin fragments with less than 18 saccharide residues have been reported to inhibit the binding of vascular endothelial growth factor (VEGF) to its receptors on endothelial cells. It has been shown that LMWH, in contrast with UFH, can hinder the binding of growth factors to their high-affinity receptors as a result of its smaller size. In vitro heparin fragments of less than 18 saccharide residues reduce the activity of VEGF, and fragments of less than 10 saccharide residues inhibit the activity of bFGF. Small molecular heparin fractions have also been shown to inhibit VEGF-and bFGF-mediated angiogenesis in vivo, in contrast with UFH. Moreover, heparin may influence malignant cell growth through other different interrelated mechanisms: inhibition of (1) heparin-binding growth factors that drive malignant cell growth; (2) tumour cell heparinases that mediate tumour cell invasion and metastasis; (3) cell surface selectin-mediated tumour cell metastasis and blood coagulation. The above evidence, together with favourable pharmaco-properties and with a reduction in major bleeding complications, suggests an important role for LMWHs in thromboprophylaxis and in the therapy of venous thromboembolism in cancer patients. There is sufficient experimental data to suggest that heparins may interfere with various aspects of cancer proliferation, angiogenesis, and meta...

show abstract

Section: Thromboprophylaxis In Cancer Patientssupporting

confidence: 69%

The heparins and cancer: review of clinical trials and biological properties

2004

View full text Add to dashboard Cite

show abstract

“…4,5 Autopsy studies have reported that patients with cancers involving organs of the abdominal cavity, particularly ovarian, biliary, or stomach cancer, have a high prevalence of pulmonary embolism at the time of death. 6 No population-based study, to our knowledge, has determined the incidence of thromboembolism among patients diagnosed with specific types and stages of cancer.…”

Section: A L T H O U G H C a N C E R I Smentioning

confidence: 99%

Incidence of Venous Thromboembolism and Its Effect on Survival Among Patients With Common Cancers

Chew¹

2006

Archives of Internal Medicine

335

352

View full text Add to dashboard Cite

show abstract

“…A study of 21,530 Swedish autopsies [5]over a 24-year period showed the highest prevalence of pulmonary embolism (PE) in patients with ovarian cancer, cancer of the extrahepatic bile duct system and cancer of the stomach (34.6, 31.7 and 15.2%, respectively). Patients with cancer of the oesophagus and larynx, leukaemia, myelomatosis and malignant lymphoma had the lowest prevalence (0–5.6%).…”

Section: Risk Of Vte In Cancermentioning

confidence: 99%

Thromboprophylaxis in the Cancer Patient

2001

View full text Add to dashboard Cite

Cancer patients not undergoing treatment and without a history of venous thrombosis do not, as a general rule, require prophylaxis. However, venous thromboembolism is of sufficient magnitude in patients undergoing treatment for cancer for thromboprophylaxis to be routinely employed. The mainstay of primary prevention is low molecular weight heparin, while secondary prevention may require warfarin and in some instances vena cava filters. The duration of prophylaxis should usually last for the period of treatment, except in the case of pelvic or cerebral radiotherapy where it is continued for 4–12 months beyond the treatment period. The principal role for vena cava filters is on occasions where recurrent thrombosis or haemorrhage complicates anticoagulation.

show abstract

Prevalence of pulmonary embolism at necropsy in patients with cancer.

Cited by 94 publications

References 18 publications

The heparins and cancer: review of clinical trials and biological properties

The heparins and cancer: review of clinical trials and biological properties

Incidence of Venous Thromboembolism and Its Effect on Survival Among Patients With Common Cancers

Thromboprophylaxis in the Cancer Patient

Contact Info

Product

Resources

About