Abstract
An increased risk of venous thromboembolism (VTE) in patients with malignancy compared with the current population is determined by risk factors including the use of anticancer treatments, in particular some hormonal drugs, cytostatics, vascular endothelial growth factor (VEGF) inhibitors and epidermal receptor growth factor (EGFR) inhibitors, immunomodulators, and erythropoietins. The population of cancer patients is divided into a group of individuals with a history of malignant disease in complete remission and patients with active (locally advanced or metastatic) malignant disease in terms of approach to VTE.
Venous thromboembolism negatively influences the prognosis of a patient with malignancy. Cancer associated VTE is associated with higher risk of recurrence as well as higher risk of bleeding during anticoagulation.
For initial and long-term treatment, low molecular weight heparin should be preferred, for a minimum of 3-6 months. Some subgroups deserve a special approach - patients with thrombocytopenia, renal insufficiency, and patients with recurrent VTE despite anticoagulation.
The treatment of an incidental pulmonary embolism is another controversial issue. The approach to a patient with cancer associated VTE should be individualized and should take into account patient's overall prognosis and risk/benefit ratio of treatment.