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Venous Thromboembolism in Cancer Patients under Palliative Care: Retrospective Study and Lessons for the Future

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Author(s): Thierry Merminod | Gilbert B Zulian

Journal: The Asia-Pacific Journal of Oncology & Hematology
ISSN 1759-6637

Volume: 2;
Issue: 1;
Start page: 15;
Date: 2010;
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Keywords: Cancer | palliative care | thromboembolism

ABSTRACT
The exact incidence of venous thromboembolic events in advanced cancer patients under palliative care is unknown. In this context, prophylactic anticoagulation with the aim of improving symptom control is a matter of debate. The clinical notes of 1000 consecutive cancer patients who died in palliative care over a period of 6 years were thus retrospectively analyzed. Thirty deep vein thrombosis, 35 pulmonary embolisms, and 20 concomitant events were found. Four patients (4.7%) were under prophylactic anticoagulant therapy prior to the event. Thirty-eight patients with deep vein thrombosis (57%) and 14 patients with pulmonary embolisms (43%) received curative anticoagulant therapy. Cancer patients under palliative care frequently developed venous thromboembolic events. Although a minority of the patients were on anticoagulant prophylaxis, half were treated with curative intent despite being considered in palliative care. Systematic prophylactic anticoagulation of cancer patients under palliative care should thus be considered to minimize both the risk of thromboembolic events and the risk of bleeding episodes related to anticoagulant therapy.
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