Cancer and thrombosis

Abstract

Venous thromboembolism is a frequent complication in cancer patients. The pathogenesis of Trousseau's syndrome might be driven by the transcriptional response to the MET oncogene, including prominent upregulation of plasminogen activator inhibitor type 1 and cyclooxygenase-2 genes. Vascular intimal carcinomatosis refers to a characteristic tumor proliferation on vascular intima that replaces the normal endothelium. Annexin2-mediated fibrinolysis on carcinoma cells may play a role in inducing hemorrhagic disorder in vascular intimal carcinomatosis. It would be an advantage to have knowledge of predictive parameters for the development of thrombosis and to be able to select cancer patients individually according to their risk profile. Thromboprophylaxis in hospitalized and cancer patients for surgery should include low-molecular weight or unfractionated heparin unless contraindicated. By contrast, in outpatients with cancer, routine anticoagulant prophylaxis is recommended only for patients with myeloma receiving thalidomide-based regimens.