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Evidence summaries

Duration of Prophylaxis Against Venous Thromboembolism after Surgery for Cancer

Four weeks of enoxaparin appears to reduce the risk of venous thromboembolism compared to 6-10 days of treatment after surgery for cancer (NNT = 14). Level of evidence: "B"

Patients undergoing curative open surgery for abdominal or pelvic cancer (n=332 included in the intention-to-treat analysis) were randomised to receive enoxaparin (40 mg subcutaneously) for 6 to 10 days and after that either enoxaparin or placebo for another 21 days 1. Bilateral venography was performed between days 25 and 31. The rates of venous thromboembolism were 12.0 percent in the placebo group and 4.8 percent in the enoxaparin group (p=0.02). The difference persisted for 3 months (13.8 vs 5.5 percent). Three patients in the enoxaparin group and six patients in the placebo group died within 3 months after surgery.

Comment: The quality of evidence is downgraded by potential reporting bias (no systematic literature search was performed).

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References

  • Bergqvist D, Agnelli G, Cohen AT, Eldor A, Nilsson PE, Le Moigne-Amrani A, Dietrich-Neto F, ENOXACAN II Investigators. Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer. N Engl J Med 2002 Mar 28;346(13):975-80. [PubMed]

Primary/Secondary Keywords