Prophylaxis against Venous Thromboembolism in Ambulatory Patients with Cancer  

Oleh:

Connors, Jean M.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 370 no. 26 (Jun. 2014), page 2515-2519.

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2014.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

The risk of venous thromboembolism is four to seven times as high among patients with cancer as among persons without this disease. 1,2 This risk is highest for patients with certain types of solid tumors and hematologic cancers and is increased for patients who are receiving chemotherapy or radiotherapy, who have undergone operative procedures, who have metastatic disease, or who have inherited thrombophilias. Studies have indicated that the mechanisms of this effect may include mucin production by tumors, exposure of tissue factor–rich surfaces and tissue factor–bearing microparticles, cysteine proteinase production leading to thrombin generation, and local hypoxia.3,4 Venous thromboembolism is the second leading cause of death in patients with cancer,5 and overall mortality is increased among patients who have both conditions. In one study, the 1-year survival rate among these patients was one third the survival rate among patients who had cancer but did not have venous thromboembolism.6 The incidence of cancer-associated thrombosis has increased,7-10 probably because of a combination of improved treatment outcomes resulting in longer patient survival, more aggressive and prothrombotic treatment regimens, an aging population, and increased detection owing to improvements in imaging technology and the frequency of imaging.

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