Dataset Information

Can thromboprophylaxis build a link for cancer patients undergoing surgical and/or chemotherapy treatment? The MeTHOS cohort study.

ABSTRACT:

Background

Patients with active cancer have a 4-sevenfold increased risk for venous thromboembolism (VTE) especially during systematic anticancer treatment. Simultaneously, surgery is an additional risk factor.

Methods

The Metaxas's Hospital THromboprophylaxis program in Oncological & Surgical Patients (MeTHOS) is a prospective, phase IV, observational, non-interventional cohort study, aiming to record the thromboprophylaxis practice patterns in high-risk active cancer patients undergoing surgical and/or chemotherapy treatment.

Results

We are reporting results from 291 ambulatory patients (median age: 67 years, Q1-Q3: 59-73 years, 54.6% males) who received anti-neoplastic treatment and administered thromboprophylaxis. 59.8% had cardiovascular disease (mostly hypertension), 76.6% were reported as having at least one comorbidity, while 27.5% and 15.8% accumulated two and three comorbidities, respectively. 94.9% of the patients were receiving highly thrombogenic agents such as platinum-based agents, 5-FU, immunotherapy, antiangiogenics/anti-VEGF, or erythropoietin. 26.5% of the patients were initially surgically treated. In terms of anticoagulation, all patients were treated with tinzaparin (fixed dose, 10,000 Anti-Xa IU, OD). The median anticoagulation duration was 6.2 months. Six thrombotic events were observed (2.06%, 95% CI: 0.76-4.43%): 5 were DVT, and one PE. With respect to safety, 7 bleeding events occurred (2.6%, 95% CI: 1.0-5.3%); 6 of them were minor.

Conclusions

Thromboprophylaxis with LMWH in patients with active cancer and high thrombotic burden was safe and effective. Intermediate dose of tinzaparin seems to be an appropriate agent for cancer-associated thromboprophylaxis management.

Clinical trial registration

ClinicalTrials.gov: NCT04248348.

SUBMITTER: Xynogalos S

PROVIDER: S-EPMC9213358 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Can thromboprophylaxis build a link for cancer patients undergoing surgical and/or chemotherapy treatment? The MeTHOS cohort study.

Xynogalos Spyridon S Simeonidis David D Papageorgiou George G Pouliakis Abraham A Charalambakis Nikolaos N Lianos Evangelos E Mazlimoglou Evridiki E Liatsos Alexandros-Nikolaos AN Kosmas Christos C Ziras Nicolaos N

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 20220512 8

<h4>Background</h4>Patients with active cancer have a 4-sevenfold increased risk for venous thromboembolism (VTE) especially during systematic anticancer treatment. Simultaneously, surgery is an additional risk factor.<h4>Methods</h4>The Metaxas's Hospital THromboprophylaxis program in Oncological & Surgical Patients (MeTHOS) is a prospective, phase IV, observational, non-interventional cohort study, aiming to record the thromboprophylaxis practice patterns in high-risk active cancer patients un ...[more]

PMID: 35552827

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Project description:IntroductionLifestyle-associated factors like physical activity (PA) play an important role in cancer prevention and oncology treatment outcomes. The aim of the study is to investigate the level of kinesiophobia (fear of movement) in breast cancer (BC) patients undergoing surgical treatment depending on socio-demographic variables, lifestyle before cancer diagnosis, stage and type of BC and comorbidities.MethodsWe interviewed 285 women (132 patients from Greater Poland Cancer Center - age: 55.7 ± 12.4; BMI: 26.7 ± 4.7 and 153 healthy women from control group - age: 49.0 ± 15.7; BMI: 25.7 ± 4.0) using Polish adaptation of the Tampa Scale of Kinesiophobia (TSK).ResultsResearch results show that women with BC suffer from kinesiophobia (>37 points) signi!cantly. Approximately 3/4 of the surveyed women with BC did not know the World Health Organization (WHO) recommendations regarding the weekly dose of PA for healthy people and for people with cancer. Before cancer diagnosis more than a half of women (60%) performed PA in accordance with WHO recommendations. 7% less women performed PA during oncology treatment. Almost a half of patients are not physically active during cancer treatment and 1/5 of the respondents declared that they do not know yet if they will be physically active after oncology treatment. The level of kinesiophobia in BC women with comorbidities was the same as in the group of BC women without comorbidities. However, the highest levels of fear of movement have been observed among women with BC suffering also from osteoporosis, obesity and diabetes. In general, higher levels of kinesiophobia were reported among women in less advanced stages of the disease. There were no differences in the level of kinesiophobia depending on the type of BC (hormonally dependent luminal cancers vs. other types). The level of kinesiophobia did not differ between women who were physically active before BC diagnosis and women who were not. In terms of socio- demographic variables, we found one direct association between the level of kinesiophobia (pain) with age - the greater age, the higher level of pain kinesiophobia.DiscussionResearch on fear of movement in female oncology requires further research (including also chemotherapy, radiotherapy, immunotherapy and hormonal therapy) and in order to effectively eliminate hypokinetic attitudes at every stage of cancer treatment.

Project description:The impact of pharmacologic prophylaxis for venous thromboembolism in patients undergoing neurosurgical intervention remains uncertain. We reviewed the efficacy and safety of pharmacologic compared with nonpharmacologic thromboprophylaxis in neurosurgical patients. Three databases were searched through April 2018, including those for randomized controlled trials (RCTs) and for nonrandomized controlled studies (NRSs). Independent reviewers assessed the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Seven RCTs and 3 NRSs proved eligible. No studies reported on symptomatic proximal and distal deep vein thrombosis (DVT). Two RCTs reported on screening-detected proximal and distal DVTs. We used the findings of these 2 RCTs as the closest surrogate outcomes to inform the proximal and distal DVT outcomes. These 2 RCTs suggest that pharmacologic thromboprophylaxis may decrease the risk of developing asymptomatic proximal DVT (relative risk [RR], 0.50; 95% confidence interval [CI], 0.30-0.84; low certainty). Findings were uncertain for mortality (RR, 1.27; 95% CI, 0.57-2.86; low certainty), symptomatic pulmonary embolism (PE) (RR, 0.84; 95% CI, 0.03-27.42; very low certainty), asymptomatic distal DVT (RR, 0.54; 95% CI, 0.27-1.08; very low certainty), and reoperation (RR, 0.43; 95% CI, 0.06-2.84; very low certainty) outcomes. NRSs also reported uncertain findings for whether pharmacologic prophylaxis affects mortality (RR, 0.72; 95% CI, 0.46-1.13; low certainty) and PE (RR, 0.18; 95% CI, 0.01-3.76). For risk of bleeding, findings were uncertain in both RCTs (RR, 1.57; 95% CI, 0.70-3.50; low certainty) and NRSs (RR, 1.45; 95% CI, 0.30-7.12; very low certainty). In patients undergoing neurosurgical procedures, low certainty of evidence suggests that pharmacologic thromboprophylaxis confers benefit for preventing asymptomatic (screening-detected) proximal DVT with very low certainty regarding its impact on patient-important outcomes.

Dataset Information

Can thromboprophylaxis build a link for cancer patients undergoing surgical and/or chemotherapy treatment? The MeTHOS cohort study.

Background

Methods

Results

Conclusions

Clinical trial registration

Publications

Can thromboprophylaxis build a link for cancer patients undergoing surgical and/or chemotherapy treatment? The MeTHOS cohort study.

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