Location of metastasis and complications in patients with venous thromboembolism and cancer: systematic review

M. Barca-Hernando, Victor Garcia-Garcia, L. Jara-Palomares
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Abstract

According to current guidelines, patients with venous thromboembolism (VTE) and active cancer should receive prolonged anticoagulant treatment (>6 months). In patients with cancer-associated thrombosis (CAT), metastasis is a factor in recurrent VTE and bleeding; however, the function of metastasis location remains unclear. In order to assess the risk of complications (such as bleeding or recurrent VTE) based on the location of metastases in patients with CAT, we conducted a systematic review. The PubMed database search was used to perform a systematic review. MESH terms pertaining to metastasis, VTE, and neoplasms were employed. Patients with CAT who were at least eighteen years old and receiving therapeutic doses of anticoagulants were included, as were details regarding the locations of metastases and the availability of patients who had complications (bleeding or recurrent VTE). Among the 1,447 articles found by the search, 7 retrospective studies met all eligibility requirements and were added to the analysis. The majority of these studies addressed brain metastases. Studies found that intracranial hemorrhage occurred between 4% and 19% of the time. In the context of brain metastases and VTE, other studies examined the safety and effectiveness of direct oral anticoagulants in comparison to low-molecular-weight heparin. This systematic review draws attention to the paucity of data regarding the impact of metastasis location on complications in CAT patients. Further research is required to assess the effect of metastasis location on the risk of VTE complications in patients with CAT.
静脉血栓栓塞症和癌症患者的转移位置与并发症:系统性综述
根据现行指南,静脉血栓栓塞症(VTE)和活动性癌症患者应接受长期抗凝治疗(>6 个月)。在癌症相关血栓形成(CAT)患者中,转移是导致复发性 VTE 和出血的一个因素;然而,转移位置的作用仍不明确。为了根据 CAT 患者转移瘤的位置评估并发症(如出血或复发性 VTE)的风险,我们进行了一项系统性综述。我们使用 PubMed 数据库进行了系统性回顾。采用了与转移、VTE 和肿瘤有关的 MESH 术语。研究对象包括年满 18 周岁且正在接受治疗剂量抗凝药物的 CAT 患者,以及转移灶位置和出现并发症(出血或复发性 VTE)患者的详细情况。在搜索到的 1,447 篇文章中,有 7 项回顾性研究符合所有资格要求并被纳入分析。这些研究大多涉及脑转移。研究发现,颅内出血的发生率在 4% 到 19% 之间。针对脑转移和 VTE,其他研究考察了直接口服抗凝剂与低分子量肝素相比的安全性和有效性。本系统综述提醒人们注意有关转移瘤位置对 CAT 患者并发症影响的数据很少。需要进一步研究评估转移瘤位置对CAT患者VTE并发症风险的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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