The effect of low molecular weight heparin on survival in patients with cancer

The association between cancer and venous thromboembolism (VTE) is well established. Of all new venous tromboembolism, approximately 20% are associated with active malignancy. In these cases, the pathogenic mechanisms of thrombosis involve a complex interaction between tumour cells, the haemostatic system, and charateristics of the patient. Anticoagulants are the mainstay therapy for the prevention and treatment of acute VTE. The natural history of VTE is more agressive and anticoagulant treatment failure is more frequent in cancer patients than in patients without cancer. Recently, the results of new prospective randomized clinical trials to evaluate the effect of low-molecular-weight heparin on cancer survival have become available. The results suggest a benefit from treatment, particularly in patients with nonadvanced disease. However, these results are not conclusive and require further research.

Keywords: Anticoagulants/adverse effects; heparin, low-molecularweight; neoplasms/complications/drug therapy; survival analysis; venous thrombosis/drug therapy/etiology