The following is a summary of “Efficacy and safety of direct oral anticoagulants versus low-molecular-weight heparin for thromboprophylaxis after cancer surgery: a systematic review and meta-analysis,” published in the February 2024 issue of Surgery by Zhou et al.
Thromboprophylaxis following cancer surgery remains a critical aspect of patient care, with the choice between direct oral anticoagulants (DOACs) and low-molecular-weight heparin (LMWH) posing a significant clinical dilemma. To address this uncertainty, this study aimed to comprehensively assess the efficacy and safety profiles of DOACs compared to LMWH in this patient population. Through meticulous literature searches spanning major databases up to July 25, 2023, encompassing both randomized controlled trials (RCTs) and observational studies, the investigation included a total of 10 studies, comprising 3,054 patients who received postoperative thromboprophylaxis with either DOACs or LMWH.
The analysis revealed that DOACs demonstrated comparable efficacy to LMWH in preventing venous thromboembolic events (VTE), major bleeding, and clinically relevant non-major bleeding (CRNMB) within the crucial 30-day postoperative window. This finding underscores the potential of DOACs as viable alternatives for thromboprophylaxis in cancer surgery patients, offering reassurance regarding safety by not increasing the risk of major bleeding events. Further subgroup analyses suggested consistency across various study parameters, including study type, extended thromboprophylaxis duration, tumor types, and specific DOAC agents employed.
Overall, these results provide valuable insights into the comparative effectiveness and safety profiles of DOACs versus LMWH in the context of postoperative thromboprophylaxis for cancer surgery patients, guiding clinical decision-making and optimizing patient care strategies.
Source: wjso.biomedcentral.com/articles/10.1186/s12957-024-03341-5