Primary prevention and treatment of venous thromboembolic events in patients with gastrointestinal cancers - Review

Factors associated with thromboembolic events following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

“…The median intensive care unit (ICU) stay and overall hospital stay were 3 and 16 (10.5‐26.5), respectively. The median highest postoperative platelet count was 423 (284‐743) × 10 9 /l; and was encountered at a median of 10 days following surgery. Overall, 90 (46.9%) patients developed postoperative thrombocytosis (>450 × 10 9 /l); of them, 25 (13.0%) experienced extreme thrombocytosis (>1000 × 10 9 /l).…”

“…In addition, there is limited data to support specific recommendations regarding VTE prophylaxis following CRS/HIPEC. While current guidelines support the administration of perioperative thromboprophylaxis, the role of an extended course of anticoagulation beyond the hospital stay is inconclusive …”

Use of Direct Oral Anticoagulants in Patients with Cancer: Practical Considerations for the Management of Patients with Nausea or Vomiting

“…The risk of VTE is particularly high in patients with gastrointestinal cancer (e.g., gastric cancer or pancreatic cancer), and gastrointestinal cancer may also be complicated by splanchnic vein thrombosis, portal hypertension, hepatopathy‐associated coagulation defects and thrombocytopenia . However, clinical data on VTE prevention and treatment specifically in this patient population are scarce.…”

“…DOACs may be a reasonable anticoagulant choice in patients with cancer, given that they do not need frequent laboratory monitoring and are much less sensitive to dietary changes or drug interactions than VKAs, and less costly and burdensome than LMWHs. However, the reliance of DOACs on oral intake and gastrointestinal absorption means that their efficacy may be affected by both the symptoms of cancer and any associated treatments . Nausea and vomiting, frequent side effects of cancer and cancer treatments , are a particular concern because they may affect the administration and/or absorption of DOACs, thereby increasing the risk of thromboembolic events.…”

Venous Thromboembolism in Adolescents

“…1 Risk factors included immobility (from surgery, recent hospitalization, or paraplegia), cancer, use of oral contraceptives, current pregnancy, and family history of VTE. For the study, researchers retrospectively identified children aged 12-17 years who had been diagnosed with VTE between 2008 and 2014 at 1 of the 8 centers.…”