Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States of America.
Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Reproductive Health, Rutgers New Jersey Medical School, Newark, NJ, United States of America.
Gynecol Oncol. 2021 Jan;160(1):312-321. doi: 10.1016/j.ygyno.2020.11.020. Epub 2020 Nov 28.
Venous thromboembolism (VTE) is a common cause of morbidity and mortality in women with gynecologic malignancies. This practice statement provides clinical data and overall quality of evidence regarding the use of direct oral anticoagulants (DOACs) in this patient population. Specifically, it reviews patient selection, safety measures, and nuances of perioperative use of these medications. The scope of this document is limited to DOAC use in gynecologic oncology rather than a broad discussion of VTE prophylaxis and management in general. The following recommendations and examination of extant data are based on DOAC trials conducted primarily in mixed populations with different cancer subtypes. Many of these trials include few, or no, women with gynecologic cancer. However, because there is very limited data in gynecologic cancer-specific populations, the results of these studies represent the best available evidence to support treatment recommendations in our patients. The members of the Society of Gynecologic Oncology (SGO) Clinical Practice Committee believe that the results of these studies may be extrapolated, with caution, to VTE treatment and prophylaxis for patients with gynecologic cancer.
静脉血栓栓塞症（VTE）是妇科恶性肿瘤患者发病率和死亡率的常见原因。本实践声明提供了关于在该患者人群中使用直接口服抗凝剂（DOAC）的临床数据和整体证据质量。具体而言，它回顾了这些药物的患者选择、安全措施和围手术期使用的细微差别。本文档的范围仅限于妇科肿瘤学中 DOAC 的使用，而不是广泛讨论一般的 VTE 预防和管理。以下建议和对现有数据的检查是基于主要在具有不同癌症亚型的混合人群中进行的 DOAC 试验。这些试验中的许多试验仅包括少数或没有妇科癌症患者。然而，由于妇科癌症特定人群中数据非常有限，因此这些研究的结果代表了支持我们患者治疗建议的最佳现有证据。妇科肿瘤学学会（SGO）临床实践委员会的成员认为，可以谨慎地推断这些研究的结果，以用于治疗和预防妇科癌症患者的 VTE。
