Soff Gerald
Memorial Sloan-Kettering Cancer Center, 1275 York Ave, Howard-717, New York, NY, 10065, USA.
Cancer Treat Res. 2019;179:1-9. doi: 10.1007/978-3-030-20315-3_1.
"The frequent concurrence of phlegmasia alba dolens with an appreciable cancerous tumor, led me to the inquiry whether a relationship of cause and effect did not exist between the two, and whether the phlegmasia was not the consequence of the cancerous cachexia." (translated from the original French). This famous quote, delivered in a lecture by Armand Trousseau in 1865, is widely recognized as the initial and insightful understanding of the relationship of thrombosis and cancer.Although the association of thrombosis with cancer has been recognized for over 150 years, only recently has there been meaningful advances in our understanding of the relationship. Contemporary translational research tools have greatly enhanced our understanding the unique aspects of the pathophysiology of the relationship; how cancer cells exploit multiple aspects of the coagulation system for primary and metastatic growth leading, leading to an increased thrombotic risk. Further, there has been a growing appreciation of the complexity of the treatment of cancer-associated thrombosis. The superiority of low molecular weight heparin over warfarin, published in 2003, represented the first important divergence from the approach to management of thrombosis in the non-cancer population. With the introduction of the new generation of anticoagulants, the direct oral anticoagulants, there has been continued evolution of management guidelines.This text presents a much needed and comprehensive update of the field of thrombosis and hemostasis in cancer. We are fortunate to have so many leading authorities contribute their expertise and insight into this work. In the following chapters, the reader will find insight and guidance that will enhance scholarship, as well as patient care.
“白发性疼痛性静脉炎常与明显的癌性肿瘤同时出现，这使我探究两者之间是否不存在因果关系，以及静脉炎是否不是癌性恶病质的后果。”（译自原文法语）。这句由阿尔芒·特鲁索于1865年在一次讲座中发表的名言，被广泛认为是对血栓形成与癌症关系的最初且有深刻见解的认识。尽管血栓形成与癌症的关联已被认识超过150年，但直到最近我们对这种关系的理解才取得了有意义的进展。当代转化研究工具极大地增进了我们对这种关系病理生理学独特方面的理解；癌细胞如何利用凝血系统的多个方面实现原发和转移生长，从而导致血栓形成风险增加。此外，人们越来越认识到癌症相关血栓形成治疗的复杂性。2003年发表的低分子量肝素对比华法林的优越性，代表了与非癌症人群血栓形成管理方法的首次重要分歧。随着新一代抗凝剂即直接口服抗凝剂的引入，管理指南不断演变。本文对癌症中的血栓形成和止血领域进行了非常必要且全面的更新。我们很幸运有这么多权威专家为这项工作贡献他们的专业知识和见解。在接下来的章节中，读者将找到能增进学术研究以及患者护理的见解和指导。
