This review highlights the critical role of low-molecular weight heparins in managing cancer-associated VTE and notes the high prevalence of occult malignancy in idiopathic VTE.
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Supports LMWH preference in cancer VTE; leaves open optimal malignancy screening in idiopathic cases.
Venous thromboembolism is a common occurrence inpatients with cancer. Among risk factors for thromboembolism are prolonged immobilization, especially during hospital stay, surgery, and chemotherapy with or without adjuvant hormone therapy. Although prophylaxis and treatment of thromboembolism in cancer patients encompass those agents that are commonly utilised in patients free from malignancy, there are many unique issues in cancer patients that often make their use more problematic. Low-molecular weight heparins are the cornerstone of prophylaxis and treatment of venous thromboembolism in cancer patients. Furthermore, they have the potential to prolong patients survival, at least in those with more favourable prognosis. Approximately 10% of patients with idiopathic venous thromboembolism harbour an underlying malignancy that can be detected by an extensive diagnostic work-up. However, whether screening for occult malignancies ultimately improves prognosis and prolongs survival remains to be demonstrated.
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Paolo Prandoni (2006) studied this question.
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