ArticleGynecologic oncology2024
Efficacy, safety, and feasibility of Apixaban for postoperative venous thromboembolism prophylaxis following open gynecologic cancer surgery at a comprehensive cancer center.
Article in Gynecologic oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Apixaban Versus Low-Molecular-Weight Heparin in Cancer-Associated Thrombosis: An Indication-Stratified Systematic Review and Meta-Analysis of Treatment and Postoperative Prophylaxis.Cardiovascular drugs and therapy · 2026Pooled it
- Apixaban Versus LMWH in CAT/VTE: A Comment on Clinical and Methodological Heterogeneity.Cardiovascular drugs and therapy · 2026Article
- Safety and efficacy of apixaban versus enoxaparin in gynecologic cancer patients undergoing open surgery: an open-label randomized controlled trial.Thrombosis journal · 2026Article
- Direct oral anticoagulants versus low-molecular-weight heparin for thromboprophylaxis in cancer-related surgeries: A meta-analysis of efficacy and safety outcomes.American heart journal plus : cardiology research and practice · 2025Review
- A Predictive Model Based on Machine Learning Algorithm for Vein Thrombosis After Ovarian Cancer Resection.International journal of women's health · 2025Article
- The Use of Apixaban for Postoperative Venous Thromboembolism Prophylaxis in Gynecologic Cancer.Annals of surgical oncology · 2024Article
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo evaluate safety, efficacy, and feasibility of apixaban for postoperative venous thromboembolism (VTE) prophylaxis following open gynecologic cancer surgery at a comprehensive cancer center.
methodsThis retrospective, cohort study included patients with gynecologic cancer who underwent open surgery between 3/2021 and 3/2023 and received 28-day postoperative VTE prophylaxis. Patients on therapeutic anticoagulation preoperatively were excluded. Predictors of 90- and 30-day VTE and 30-day bleeding events were determined using multivariable logistic regression, adjusting for known confounders.
results452 patients were included in the cohort: 348 received apixaban and 104 received enoxaparin. Those who received enoxaparin were more likely to be American Society of Anesthesiologists class III/IV (compared to I/II) (p = 0.033), current or former smokers (p = 0.012) and have a higher BMI (p < 0.001), Charlson Comorbidity Index (p = 0.005), and age (p = 0.046). 30-day VTE rate was significantly lower in the apixaban group (0.6%) compared to the enoxaparin group (6.2%) (adjusted OR 0.13, 95% CI 0.03-0.56; p = 0.006). 90-day VTE rate was 2.7% and 6.2% in the apixaban and enoxaparin groups, respectively (adjusted OR 0.85, 95% CI 0.38-1.92; p = 0.704). Major bleeding complications (2.4% vs. 2.0%) and minor bleeding complications (0.9% vs. 3.0%) were similar in the apixaban and enoxaparin groups, respectively, on multivariate analyses. The median patient out of pocket cost was $10 (IQR 0.0-40.0) for apixaban and $20 (IQR 3.7-67.7) for enoxaparin (p = 0.001).
conclusionsOur findings along with previously published data suggest that apixaban should be considered the standard of care for VTE prophylaxis in patients undergoing open surgery for gynecologic malignancies.
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