Mulder Frits I, Bosch Floris T M, van Es Nick
Department of Vascular Medicine, Amsterdam Cardiovascular Science, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Department of Internal Medicine, Tergooi Hospitals, 1213 XZ Hilversum, The Netherlands.
Cancers (Basel). 2020 Feb 5;12(2):367. doi: 10.3390/cancers12020367.
Venous thromboembolism (VTE), comprising deep-vein thrombosis and pulmonary embolism, is a frequent complication in ambulatory cancer patients. Despite the high risk, routine thromboprophylaxis is not recommended because of the high number needed to treat and the risk of bleeding. Two recent trials demonstrated that the number needed to treat can be reduced by selecting cancer patients at high risk for VTE with prediction scores, leading the latest guidelines to suggest such an approach in clinical practice. Yet, the interpretation of these trial results and the translation of the guideline recommendations to clinical practice may be less straightforward. In this clinically-oriented review, some of the controversies are addressed by focusing on the burden of VTE in cancer patients, discussing the performance of available risk assessment scores, and summarizing the findings of recent trials. This overview can help oncologists, hematologists, and vascular medicine specialists decide about thromboprophylaxis in ambulatory cancer patients.
静脉血栓栓塞症（VTE），包括深静脉血栓形成和肺栓塞，是门诊癌症患者常见的并发症。尽管风险很高，但由于治疗所需人数众多以及出血风险，不建议进行常规血栓预防。最近的两项试验表明，通过使用预测评分选择VTE高危癌症患者，可以减少治疗所需人数，这使得最新指南建议在临床实践中采用这种方法。然而，对这些试验结果的解释以及将指南建议转化为临床实践可能并非那么简单直接。在这篇以临床为导向的综述中，通过关注癌症患者VTE的负担、讨论现有风险评估评分的性能以及总结近期试验的结果，解决了一些争议问题。本综述有助于肿瘤学家、血液学家和血管医学专家就门诊癌症患者的血栓预防做出决策。
