Trombosis en el paciente con cáncer

Abstract

Oncological diseases significantly increase the risk of thrombosis, which is especially high in certain types of cancer (pancreatic, gastric, cerebral) and therapies (cisplatin, tamoxifen, antiangiogenic drugs). Antithrombotic prophylaxis in oncology patients depends on individual risk and may include both low-molecular-weight heparins and oral anticoagulants (individualized according to patient characteristics). Hospitalized patients who are immobile should receive prophylaxis if they are not at high risk of bleeding. For major surgeries, prophylaxis is started 12 hours afterwards and can be extended up to four weeks. In outpatients, the Khorana score is used to assess risk. The duration of treatment varies (in general it is maintained for at least six months) and, in cases of recurrence, the dosage is adjusted or the type of anticoagulant is changed. Catheter-associated thrombosis requires anticoagulation, avoiding catheter removal if the catheter is functioning and not infected