Guidelines on the prevention and treatment of venous thromboembolism in cancer patients treated surgically, including patients under 18 years of age

Abstract

Venous thromboembolism (VTE) is one of the most dangerous complications of cancer. Oncological treatment, surgeries and advanced-stage cancer are only some of the risk factors for VTE, which is still one of the most common causes of death in the population of cancer patients. Differences in the risk of deep-venous thrombosis and its complications, including risk of bleeding, between particular oncological patient groups suggests that there is a need for individual risk assessment and prophylaxis dedicated to specific clinical situations and patients. Cancer-related thrombosis (CAT) is the second most common cause of death in cancer patients. In view of the dynamically growing body of evidence on CAT in recent years, there is a need to update the guidelines for prevention and treatment offered to cancer patients, as evidenced by this document, which is an update of the guidelines published in 2016. This document contains data published after 2016 and the most recent indications for prevention and treatment in the population of cancer patients, with particular emphasis on thromboprophylaxis in those undergoing surgical treatment. Moreover, it was extended to include indications in patients under 18 years of age. The recommendations for the treatment of cancer-related VTE and the use of thromboprophylaxis in the population of children with cancer who are scheduled for surgery were analyzed. The current recommendations confirm the leading role of low-molecular-weight heparins in the pharmacological prevention of VTE in cancer patients and indicate direct oral anticoagulants as an alternative to low-molecular-weight heparin in the treatment of CAT patients.