SynthesisJournal of experimental & clinical cancer research : CR2008
Low-molecular-weight heparins are superior to vitamin K antagonists for the long term treatment of venous thromboembolism in patients with cancer: a cochrane systematic review.
Synthesis in Journal of experimental & clinical cancer research : CR, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 83 citations in OpenAlex.
- Urinary estrogen metabolites and prostate cancer: a case-control study and meta-analysis.Journal of experimental & clinical cancer research : CR · 2009Pooled it
- Multifunctional applications and research advances of low-molecular-weight heparin.Frontiers in pharmacology · 2025Review
- Review
- Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immune checkpoint inhibitor-related adverse events.Journal for immunotherapy of cancer · 2021Article
- Duration of anticoagulant therapy and VTE recurrence in patients with cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2019Article
- Cancer and Venous Thromboembolic Disease: A Review.The oncologist · 2017Review
- The safety of low-molecular-weight heparins in the prevention of venous thromboembolism in surgically-treated cancer patients: results of a multicentre observational study.Contemporary oncology (Poznan, Poland) · 2017Article
- Guidance for the prevention and treatment of cancer-associated venous thromboembolism.Journal of thrombosis and thrombolysis · 2016Review
- Venous thromboembolism in cancer patients: an underestimated major health problem.World journal of surgical oncology · 2015Review
- Cancer-associated thrombosis, low-molecular-weight heparin, and the patient experience: a qualitative study.Patient preference and adherence · 2014Article
- Cancer and coagulation.American journal of hematology · 2012Review
- 80-year-old man with massive leg swelling.Mayo Clinic proceedings · 2011Article
- SEOM guidelines on thrombosis in cancer patients.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2011Article
- Anticoagulation in the management of venous thromboembolism in the cancer patient.Journal of thrombosis and thrombolysis · 2011Review
- Anticoagulant therapy for nodular regenerative hyperplasia in a HIV-infected patient.BMC gastroenterology · 2010Article
- New insights into cancer-associated thrombosis.Arteriosclerosis, thrombosis, and vascular biology · 2009Review
- Venous Thromboembolism In Cancer Patients: "From Evidence to Care".Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCancer and its therapies increase the risk of venous thromboembolism. Compared to patients without cancer, patients with cancer anticoagulated for venous thromboembolism are more likely to develop recurrent thrombotic events and major bleeding. Addressing all important outcomes including harm is of great importance to make evidence based health care decisions. The objective of this study was to compare low molecular weight heparin (LMWH) and oral anticoagulants (vitamin K antagonist (VKA) and ximelagatran) for the long term treatment of venous thromboembolism in patients with cancer.
methodsA systematic review of the medical literature. We followed the Cochrane Collaboration methodology for conducting systematic reviews. We assessed methodological quality for each outcome by grading the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.
resultsEight randomized controlled trials (RCTs) were eligible and reported data for patients with cancer. The quality of evidence was low for death and moderate for recurrent venous thromboembolism. LMWH, compared to VKA provided no statistically significant survival benefit (Hazard ratio (HR) = 0.96; 95% CI 0.81 to 1.14) but a statistically significant reduction in venous thromboembolism (HR = 0.47; 95% (Confidence Interval (CI) = 0.32 to 0.71). There was no statistically significant difference between LMWH and VKA in bleeding outcomes (RR = 0.91; 95% CI = 0.64 to 1.31) or thrombocytopenia (RR = 1.02; 95% CI = 0.60 to 1.74).
conclusionFor the long term treatment of venous thromboembolism in patients with cancer, LMWH compared to VKA reduces venous thromboembolism but not death.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.