Mehmet Fuat EREN, Birsen YÜCEL, Sadettin KILIÇKAP

Venous thromboembolism in cancer patients

Venöz tromboembolizm (VTE) kanser hastalığının major komplikasyonu, morbidite vemortalitenin en önemli nedenidir. Kanser hastalarında VTE insidansı %0,6-7,8 olup, kanserolmayan hastalardaki VTE insidansından 2 kat daha fazladır. Kanser hastalarında VTE görülmeriski, buna derin ven trombozu ve pulmoner embolism de eklendiğinde 2-7 kat arası artmaktadır.VTE riski özellikle hastanede yatan kanser hastalarında ve antineoplastik tedavi alanlardayüksektir. Bununla beraber büyük cerrahi operasyon geçiren hastalarda da VTE riski artmaktadır.Travma, uzun sureli yolculuk, ileri yaş, obezite, önceden geçirilmiş VTE ve genetik gibi faktörlerVTE için predispozan faktörlerdendir. Kanser hastalarındaki tromboproflaksideki primer amaçVTE gelişmesini önlemektir. Kanser hastalarının büyük bir çoğunluğu fraksiyone olmayan heparinve düşük molekül ağırlıklı heparin ile tedavi edilmelidir. Büyük cerrahi operasyon geçiren kanserhastalarında proflaksi yapılmalıdır.

Kanser hastalarında venöz tromboembolizm

Venous thromboembolism (VTE) is a major complication of cancer and represents an importantcause of morbidity and mortality. The incidence of VTE is 0.6-7.8%in patients with cancer morethan double the incidence of VTE in patients without cancer. The risk of VTE which includes deepvenous thrombosis (DVT) and pulmonary embolism (PE) is increased two to seven fold in patientswith cancer. VTE risk is especially high among certain groups such as hospitalized patients withcancer and those receiving active antineoplastic therapy. Also cancer patients, who undergoingmajor surgery, are increased risk of VTE. Trauma, long-haul travel, increased age, obesity,previous VTE and genetic component are also predisposing factors for VTE. Patients with cancerwho develop VTE should be managed multidisciplinary treatment guidelines. The primary goal ofthromboprophylaxis in patients with cancer is to prevent VTE. The large majority of cancerpatients should be treated with therapeutic doses of unfractioned heparin (UFH) or low molecularweight heparin (LMWH). Prophylaxis should include cancer patients who underwent majorsurgery for cancer and patients with a history of VTE.

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