Table 1.
Summary of VTE and Major Bleeding Rates in Trials Comparing Primary Thromboprophylaxis Strategies in Cancer Patients
| Ref. | Cancer | Patients, N | Drug | VTE Detection | VTE, % | Bleeding*, % |
|---|---|---|---|---|---|---|
| [39] | Abdominal, thoracic | 241 | Orgaran 750 IU BID | Asymptomatic VTE: 125I-fibrinogen and venography. Symptomatic VTE: DVT - venography; PE - chest X-ray, VPS |
10.4 | 9.0 (overall) |
| 249 | UFH 5,000 U BID | 14.9 | 10.6 (overall) | |||
| [40] | Abdominal, pelvic | 312 | Enoxaparin 40 mg SC | Symptomatic and asymptomatic VTE: DVT - venography; PE - VPS, pulmonary angiography | 14.7 | 14.6 (minor) 4.1 (major) |
| 319 | UFH 5,000 IU SC TID | 18.2 | 14.3 (minor) 2.9 (major) |
|||
| [41] | Gynecological | 160 | Embolex 3,000 IU OD | Asymptomatic VTE: impedance plethysmography, phlebography | 6.3 | 16.9 (wound hematoma) |
| 164 | UFH 5,000 IU TID | 6.1 | 28.7 (wound hematoma) | |||
| [42] | Gynecological | 47 | Enoxaparin 2,500 IU OD | Symptomatic VTE: DVT - ultrasonography, venography; PE - VPS, pulmonary anteriography | None | No significant difference (rates not given) |
| 55 | UFH 5,000 IU TID | None | ||||
| [43] | Colorectal (all patients)† | 674 | Enoxaparin 40 mg SC OD | Symptomatic and asymptomatic VTE: DVT - ultrasonography, venography; PE - VPS, ultrasonography, venography, pulmonary angiography | 9.4 | 10.1 (total) 2.7 (major) |
| 675 | UFH 5,000 IU SC TID | 9.4 | 6.2 (total) 1.5 (major) | |||
| Cancer sub-group | 241 | Enoxaparin 40 mg SC OD | 13.9 | Not reported | ||
| 234 | UFH 5,000 IU SC TID | 16.9 | ||||
| [44] | Abdominal (all patients)† | 1,425 | Dalteparin 5,000 IU OD | Symptomatic and asymptomatic VTE: DVT - ultrasonography, venography; PE - lung scan, pulmonary angiography, helical computed tomography, autopsy | 6.1 | 2.5 (major) |
| 1,433 | Fondaparinux 2.5 mg SC OD | 4.6 | 3.4 (major) | |||
| Cancer sub-group | 712 | Dalteparin 5,000 IU OD | 7.7 | Not reported | ||
| 696 | Fondaparinux 2.5 mg SC OD | 4.7 | ||||
| [45] | Colorectal | 486 | Enoxaparin 40 mg SC OD | Symptomatic and asymptomatic VTE: DVT - ultrasonography, venography; PE pulmonary angiography, autopsy | 12.6 | 11.5 (major) |
| 464 | Nadroparin 2,850 IU OD | 15.9 | 7.3 (major) | |||
BID, twice daily; DVT, deep vein thrombosis; OD, once daily; PE, pulmonary embolism; SC, subcutaneous; TID, three times daily; VPS; ventilation perfusion scan; VTE, venous thromboembolism; UFH, unfractionated heparin.
*For definitions of major bleeding see original studies.
†Included non-cancer patients.