Management of venous thromboembolism in patients with cancer

J Thromb Haemost. 2018 Dec;16(12):2391-2396. doi: 10.1111/jth.14305. Epub 2018 Oct 15.


Current guidelines for anticoagulant therapy do not so far suggest any form of differentiated approach to cancer patients with venous thromboembolism (VTE). This review article provides an overview of the published literature in cancer patients with VTE, mostly using data from the RIETE registry. Our findings provide some insights into what factors may be used to guide physicians in adapting recommended anticoagulant regimens to the individual patient, as oncologists are increasingly doing with cancer treatments. For instance, patients presenting with deep vein thrombosis (DVT) alone might benefit from curtailing treatment intensity as anticoagulant therapy progresses. The site of cancer also needs to be considered. In patients with incidental PE or splanchnic vein thrombosis, we should be more cautious before prescribing anticoagulant therapy. The optimal duration of anticoagulant therapy is unknown.

Keywords: anticoagulant therapy; bleeding; cancer; death; recurrences; venous thromboembolism.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anticoagulants / administration & dosage*
  • Anticoagulants / adverse effects
  • Blood Coagulation / drug effects*
  • Hemorrhage / chemically induced
  • Humans
  • Neoplasms / blood
  • Neoplasms / complications
  • Neoplasms / mortality
  • Pulmonary Embolism / blood
  • Pulmonary Embolism / drug therapy*
  • Pulmonary Embolism / etiology
  • Pulmonary Embolism / mortality
  • Recurrence
  • Registries
  • Risk Factors
  • Treatment Outcome
  • Venous Thromboembolism / blood
  • Venous Thromboembolism / drug therapy*
  • Venous Thromboembolism / etiology
  • Venous Thromboembolism / mortality
  • Venous Thrombosis / blood
  • Venous Thrombosis / drug therapy*
  • Venous Thrombosis / etiology
  • Venous Thrombosis / mortality


  • Anticoagulants