Consensus statement of the Spanish Society of Internal Medicine and the Spanish Society of Medical Oncology on secondary thromboprophylaxis in patients with cancer

Clin Transl Oncol. 2021 Apr;23(4):697-708. doi: 10.1007/s12094-020-02477-6. Epub 2020 Sep 3.

Abstract

Up to 20% of cancer patients will develop some manifestation of venous thromboembolic disease (VTD) during their clinical course. VTD greatly impacts morbidity, mortality, quality of life and pharmaceutical expenditure. In addition, both thrombotic relapse and major haemorrhages derived from VTD treatment are more likely in oncological patients. To make the decision to establish secondary thromboprophylaxis as an indefinite treatment in these patients, it is important to review all the risk factors involved, whether related to the disease, the patient or the prior thrombotic event. The objectives of this consensus of the Spanish Society of Internal Medicine (Sociedad Española de Medicina Interna-SEMI) and the Spanish Society of Medical Oncology (Sociedad Española de Oncología Médica-SEOM) are to establish recommendations that help assess the risk of recurrence of VTD and haemorrhagic risk in patients with cancer, as well as to analyse the evidence that exists on the currently available drugs, which will allow the establishment of a protocol for shared decision-making with the informed patient.

Keywords: Anticoagulants; Haemorrhage; Low-molecular-weight heparin; Neoplasms; Venous thrombosis; Vitamin K.

MeSH terms

  • Age Factors
  • Angiogenesis Inhibitors / adverse effects
  • Anticoagulants / therapeutic use
  • Antineoplastic Agents / adverse effects
  • Consensus*
  • Decision Making, Shared
  • Factor Xa Inhibitors / adverse effects
  • Factor Xa Inhibitors / therapeutic use*
  • Hemorrhage / chemically induced*
  • Humans
  • Internal Medicine
  • Medical Oncology
  • Mutation
  • Neoplasms / complications*
  • Neoplasms / genetics
  • Neoplasms / pathology
  • Neoplasms / therapy
  • Recurrence
  • Risk Factors
  • Secondary Prevention / methods*
  • Secondary Prevention / standards
  • Societies, Medical
  • Spain
  • Venous Thromboembolism / blood
  • Venous Thromboembolism / etiology
  • Venous Thromboembolism / prevention & control*

Substances

  • Angiogenesis Inhibitors
  • Anticoagulants
  • Antineoplastic Agents
  • Factor Xa Inhibitors