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May 15, 2022;14 (10):

A Systematic Review of the Guidelines on Venous Thromboembolism Prophylaxis in Gynecologic Oncology.

Federico Romano, Giovanni Di Lorenzo, Guglielmo Stabile, Mariateresa Mirandola, Stefano Restaino, Patrizia Ianniello, Giuseppe Mirenda, Giuseppe Ricci
Author Information
  1. Federico Romano: Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Via dell' Istria 65/1, 34137 Trieste, Italy. ORCID
  2. Giovanni Di Lorenzo: Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Via dell' Istria 65/1, 34137 Trieste, Italy.
  3. Guglielmo Stabile: Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Via dell' Istria 65/1, 34137 Trieste, Italy. ORCID
  4. Mariateresa Mirandola: Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34127 Trieste, Italy.
  5. Stefano Restaino: Department of Maternal and Child Health, University-Hospital of Udine, P.le S. Maria della Misericordia 15, 33100 Udine, Italy. ORCID
  6. Patrizia Ianniello: Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34127 Trieste, Italy.
  7. Giuseppe Mirenda: Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Via dell' Istria 65/1, 34137 Trieste, Italy.
  8. Giuseppe Ricci: Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Via dell' Istria 65/1, 34137 Trieste, Italy. ORCID
PMID: 35626045 DOI: 10.3390/cancers14102439

Abstract

(1) Background: This review aimed to summarize the indications for venous thromboembolic (VTE) events' prophylaxis in a gynecological cancer population, according to the most recent guidelines. (2) Methods: A systematic review of the guidelines in PubMed, SCOPUS, Web of Science, EMBASE, and CINHAL regarding VTE prevention in gynecological cancer patients was conducted according to PRISMA criteria. We compared the recommendations given by oncological and hematological societies regarding VTE prevention in gynecological cancer patients published from January 2010 through March 2021. We searched for the following keywords: "venous thromboembolism prevention", "cancer", and "guidelines". The AGREE II checklist was used to critically analyze the guidelines' quality. (3) Results: There were 1003 documents available; 14 met the inclusion criteria, 5 were excluded and, eventually, the guidelines of 10 societies were evaluated. (4) Conclusions: The guidelines agree that low-molecular-weight heparin (LMWH) and fondaparinux achieve better results in VTE prevention in gynecological cancer patients. Direct oral anticoagulants (DOACs) can be used to prevent VTE in outpatients and high-risk medical patients after discharge. VTE risk scores should be applied to all oncological patients to identify those who would benefit from a prevention program. More attention should be paid to mechanical prophylactic methods due to the high bleeding risk of gynecological cancer patients.

Keywords

deep vein thrombosis gynecological cancer pulmonary embolism thromboprophylaxis venous thromboembolism prevention

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