The safety of low-molecular-weight heparins in the prevention of venous thromboembolism in surgically-treated cancer patients: results of a multicentre observational study.

AIM OF THE STUDY: Despite widespread use of pharmacological prophylaxis, venous thromboembolism (VTE) still constitutes a common complication in cancer patients. The aim of the study was to analyse the safety of low-molecular-weight heparins (LMWH) in the prevention of VTE in surgically-treated cancer patients.

MATERIAL AND METHODS: A total of 5207 cancer patients (44.5% men and 55.5% women) aged 16-97 years participated in a prospective observational study conducted in 13 Polish cancer centres in 2005-2008. This cohort included 4782 subjects who were treated surgically and received LMWH as a pharmacological prophylaxis for VTE prior to or after the surgery. The incidence of haemorrhagic complications and thrombocytopaenia was analysed in this cohort, along with intra-hospital mortality.

RESULTS: Mean duration of LMWH administration was 9.4 ±7.8 days. Haemorrhagic complications: heavy ( n = 15) or light bleeding ( n = 299), were observed in 314 patients (6.5%). A total of 314 patients (6.5%) presented with haemorrhagic complications: heavy ( n = 15, 0.3%) or light bleeding ( n = 299, 6.3%). Four cases of heavy bleeding: gastrointestinal bleeding ( n = 2), retroperitoneal bleeding ( n = 1), and central nervous system bleeding ( n = 1), were classified as definitely related to LMWH. No significant association was found between the incidence of haemorrhagic complications and the type of administered LWMH ( p = 0.523). No cases of thrombocytopaenia or deaths related to administration of LMWH were reported.

CONCLUSIONS: LMWH seems to be a safe form of pharmacological prophylaxis for VTE in surgically-treated cancer patients.