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Carmona-Bayonas A, Sánchez-Cánovas M, Plasencia JM, Custodio A, Martínez de Castro E, Virizuela JA, Ayala de la Peña F, Jiménez-Fonseca P. Key points to optimizing management and research on cancer-associated thrombosis. Clin Transl Oncol 2017; 20:119-126. [PMID: 28593335 DOI: 10.1007/s12094-017-1692-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 05/25/2017] [Indexed: 12/12/2022]
Abstract
Despite the fact that thromboembolism is relatively common in oncology patients and that the interrelationship between thrombotic risk and specific mechanisms of tumorigenesis has long been known, many cardinal elements of prevention and treatment remain unresolved. Among the existing knowledge gaps, the need to validate the Ay scale and compare it to the Khorana index, develop, and standardize the use of predictive biomarkers for thrombotic risk, conduct clinical trials in thromboprophylaxis adapted to thrombotic risk, evaluate the efficacy and safety of direct anticoagulants, select patients who can benefit from anticoagulants for antitumor treatment, validate the EPIPHANY study decision tree to choose patients with low-risk pulmonary embolism, and accumulate more practical experience in special situations (rethrombosis, prolonged therapy beyond 6 months, etc.) are especially remarkable. These gray areas surrounding cancer-related thromboembolism explain why it continues to be a relatively common cause of serious events, at times interfering significantly with the development of new tumor-fighting strategies.
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Affiliation(s)
- A Carmona-Bayonas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, UMU, IMIB, Calle Marqués de los Vélez s/n, 30008, Murcia, Spain.
| | - M Sánchez-Cánovas
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, UMU, IMIB, Calle Marqués de los Vélez s/n, 30008, Murcia, Spain
| | - J M Plasencia
- Radiology Department, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - A Custodio
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | - E Martínez de Castro
- Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - J A Virizuela
- Medical Oncology Department, Hospital Universitario Virgen de Macarena, Seville, Spain
| | - F Ayala de la Peña
- Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, UMU, IMIB, Calle Marqués de los Vélez s/n, 30008, Murcia, Spain
| | - P Jiménez-Fonseca
- Medical Oncology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
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