Assistance Publique-Hôpitaux de Paris, Internal Medicine: Autoimmune and Vascular Disease Unit, Saint-Louis Hospital, Paris, France; Sorbonne Paris Cité, Paris 7 Diderot University, Paris, France.
Division of Angiology and Hemostasis, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Lancet Oncol. 2016 Oct;17(10):e452-e466. doi: 10.1016/S1470-2045(16)30369-2.
Venous thromboembolism (VTE) is the second leading cause of death in patients with cancer. These patients are at an increased risk of developing VTE and are more likely to have a recurrence of VTE and bleeding while taking anticoagulants. Management of VTE in patients with cancer is a major therapeutic challenge and remains suboptimal worldwide. In 2013, the International Initiative on Thrombosis and Cancer (ITAC-CME), established to reduce the global burden of VTE in patients with cancer, published international guidelines for the treatment and prophylaxis of VTE and central venous catheter-associated thrombosis. The rapid global adoption of direct oral anticoagulants for management of VTE in patients with cancer is an emerging treatment trend that needs to be addressed based on the current level of evidence. In this Review, we provide an update of the ITAC-CME consensus recommendations based on a systematic review of the literature ranked according to the Grading of Recommendations Assessment, Development, and Evaluation scale. These guidelines aim to address in-hospital and outpatient cancer-associated VTE in specific subgroups of patients with cancer.
静脉血栓栓塞症（VTE）是癌症患者的第二大死亡原因。这些患者发生 VTE 的风险增加，并且在使用抗凝剂时更有可能发生 VTE 复发和出血。癌症患者的 VTE 管理是一个主要的治疗挑战，在全球范围内仍不理想。2013 年，为了降低癌症患者 VTE 的全球负担而成立的国际血栓与癌症倡议（ITAC-CME）发布了 VTE 和中心静脉导管相关血栓形成的治疗和预防国际指南。癌症患者 VTE 管理中直接口服抗凝剂的快速全球采用是一种新兴的治疗趋势，需要根据现有证据水平进行处理。在这篇综述中，我们根据根据推荐评估、制定和评估分级的文献系统评价，提供了基于 ITAC-CME 共识建议的更新。这些指南旨在解决特定癌症患者亚组的住院和门诊癌症相关 VTE。
