Best evidence summary on anticoagulant management in patients with cancer-associated venous thromboembolism

Abstract

Objective

To retrieve, evaluate, and summarize the best evidence for anticoagulant management in patients with cancer-associated venous thromboembolism (VTE).

Methods

This was an evidence summary study conducted in strict accordance with the reporting standards of the Fudan University Center for Evidence-Based Nursing. According to the evidence pyramid “6S” model, the search was performed from top to bottom. The following databases were searched: BMJ Best Practice, UpToDate, Joanna Briggs Institute, Cochrane Library, Guidelines International Network, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses Association of Ontario, YiMaiTong Guidelines Network, PubMed, Embase, Web of Science, Sinomed, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP. Professional association websites included those of the American Society of Clinical Oncology, American Society of Hematology, British Society for Haematology, and the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. The search period was from the inception of each database to October 2024. Literature types included clinical practice guidelines, clinical decisions, expert consensuses, systematic reviews, and randomized controlled trials (RCTs).

Results

A total of 19 studies were included, comprising three clinical decisions, 10 guidelines, one expert consensus, four systematic reviews, and one RCT. Thirty-four pieces of evidence were synthesized across eight aspects: risk factor assessment, timing of anticoagulation, drug selection, treatment duration, management of recurrence, safety monitoring, health education, and follow-up care.

Conclusions

This study summarizes the best evidence for anticoagulant management in patients with cancer-associated VTE. When applying this evidence clinically, health care providers should thoroughly evaluate the feasibility and appropriateness of each recommendation to develop clinical decisions tailored to China's national conditions and health care resources.

Systematic review registration

This study has been registered on the Fudan University Centre for Evidence-based Nursing (Registration No. ES20244015).