Low molecular weight heparin versus unfractionated heparin for perioperative thromboprophylaxis in patients with cancer

Cochrane Database of Systematic Reviews

Volumn 2014, Issue 6, 2014, Pages

  Akl, Elie A ^a   Kahale, Lara A ^a   Sperati, Francesca ^b   Neumann, Ignacio ^c   Labedi, Nawman ^d   Terrenato, Irene ^b   Barba, Maddalena ^b   Sempos, Elena V ^e   Muti, Paola ^b   Cook, Deborah ^f   Schünemann, Holger ^f  

^a AMERICAN UNIVERSITY OF BEIRUT   (Lebanon)

^b REGINA ELENA NATIONAL CANCER INSTITUTE   (Italy)

^c PONTIFICIA UNIVERSIDAD CATÓLICA DE CHILE   (Chile)

^d ERIE COUNTY MEDICAL CENTER   (United States)

^e DEPARTMENT OF VETERANS AFFAIRS   (United States)

^f MCMASTER UNIVERSITY   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

HEPARIN; LOW MOLECULAR WEIGHT HEPARIN; ANTICOAGULANT AGENT;

ALL CAUSE MORTALITY; ANTICOAGULATION; BLEEDING; BLOOD TRANSFUSION; DEEP VEIN THROMBOSIS; DRUG EFFICACY; HEMATOMA; HIGH RISK PATIENT; HUMAN; LUNG EMBOLISM; MALIGNANT NEOPLASM; MORTALITY RATE; MORTALITY RISK; OUTCOME ASSESSMENT; PERIOPERATIVE THROMBOSIS; PEROPERATIVE COMPLICATION; PRIORITY JOURNAL; REOPERATION; REVIEW; RISK ASSESSMENT; RISK BENEFIT ANALYSIS; SYSTEMATIC REVIEW; THROMBOCYTOPENIA; THROMBOSIS PREVENTION; CHEMICALLY INDUCED; META ANALYSIS; MORTALITY; NEOPLASMS; POSTOPERATIVE COMPLICATIONS; PULMONARY EMBOLISM; RANDOMIZED CONTROLLED TRIAL (TOPIC); THROMBOSIS; VENOUS THROMBOSIS;

ANTICOAGULANTS; HEMORRHAGE; HEPARIN; HEPARIN, LOW-MOLECULAR-WEIGHT; HUMANS; NEOPLASMS; POSTOPERATIVE COMPLICATIONS; PULMONARY EMBOLISM; RANDOMIZED CONTROLLED TRIALS AS TOPIC; THROMBOCYTOPENIA; THROMBOSIS; VENOUS THROMBOSIS;

EID: 84942807097     PISSN: None     EISSN: 1469493X     Source Type: Journal    
DOI: 10.1002/14651858.CD009447.pub2     Document Type: Review

References (81)

1. Baykal C, Al A, Demirtas E, Ayhan A. Comparison of enoxaparin and standard heparin in gynaecologic oncologic surgery: a randomised prospective double-blind clinical study. European Journal of Gynaecological Oncology 2001;22(2):127-30.
2. Bergqvist D, Burmark US, Frisell J. Thromboprophylactic effect of low molecular weight heparin started in the evening before elective general abdominal surgery: a comparison with low-dose heparin. Seminars in Thrombosis & Hemostasis 1990;16:19-24.
3. Boncinelli S, Marsili M, Lorenzi P, Fabbri LP, Pittino S, Filoni M, et al. Haemostatic molecular markers in patients undergoing radical retropubic prostatectomy for prostate cancer and submitted to prophylaxis with unfractioned or low molecular weight heparin. Minerva Anestesiologica 2001;67(10):693-703.
4. Dahan M, Boneu B, Renella J, Berjaud J, Bogaty J, Durand J, et al. Prevention of deep venous thromboses in cancer thoracic surgery with a low-molecular-weight heparin: fraxiparine. A comparative randomized trial. Fraxiparine: Second International Symposium Recent Pharmacological and Clinical Data. New York, NY: John Wiley & Sons Inc, 1990:27-31.
5. The European Fraxiparin Study (EFS) Group. Comparison of a low molecular weight heparin and unfractionated heparin for the prevention of deep vein thrombosis in patients undergoing abdominal surgery. British Journal of Surgery 1988;75(11):1058-63.
6. Enoxacan Study Group. Efficacy and safety of enoxaparin versus unfractionated heparin for prevention of deep vein thrombosis in elective cancer surgery: a double-blind randomized multicentre trial with venographic assessment. British Journal of Surgery 1997;84(8):1099-103.
7. Fricker JP, Vergnes Y, Schach R, Heitz A, Eber M, Grunebaum L, et al. Low dose heparin versus low molecular weight heparin (Kabi 2165, Fragmin) in the prophylaxis of thromboembolic complications of abdominal oncological surgery. European Journal of Clinical Investigation 1988;18(6):561-7.
8. Grunebaum L, Fricker JP, Wiesel ML, Vergnes Y, Kapps J, Cazenave J. Preliminary results of a randomized trial comparing the efficacy of standard heparin with that of fragmine, a low molecular weight heparin, in the prevention of postoperative thrombosis in cancer surgery. Journal des Maladies Vasculaires 1987;12 Suppl B:102-4.
9. Gallus A, Cade J, Ockelford P, Hepburn S, Maas M, Magnani H, et al. Orgaran (Org 10172) or heparin for preventing venous thrombosis after elective surgery for malignant disease? A double-blind, randomised, multicentre comparison. ANZ-Organon Investigators' Group. Thrombosis and Hemostasis 1993;70(4):562-7.
10. Godwin JE, Comp P, Davidson B, Rossi M. Comparison of the efficacy and safety of subcutaneous Rd heparin vs subcutaneous unfractionated heparin for the prevention of deep-vein thrombosis in patients undergoing abdominal or pelvic-surgery for cancer. Thrombosis and Haemostasis 1993;69(6):647.
11. Haas S, Wolf H, Kakkar AK, Fareed J, Encke A. Prevention of fatal pulmonary embolism and mortality in surgical patients: a randomized double-blind comparison of LMWH with unfractionated heparin. Thrombosis and Haemostasis 2005;94:814-19.
12. Haas SK, Wolf H. Prevention of fatal pulmonary embolism and death in elective cancer surgery patients: a substudy comparison of certoparin with unfractionated heparin. Blood 2000;96(11):4039.
13. Haas, S. K, Wolf, H, Kakkar, A, Fareed, J, Encke, A. Prevention of fatal pulmonary embolism and death in elective cancer surgery patients A substudy comparison of certoparin with unfractionated heparin. Blood. 2000; Vol. 96 (11 Part 2):83b.
14. Kakkar AK, Haas S, Wolf H, Encke A. Evaluation of perioperative fatal pulmonary embolism and death in cancer surgical patients: the MC-4 cancer substudy. Thrombosis and Haemostasis 2005;94(4):867-71.
15. Anonymous. A prospective randomized study on the perioperative treatment with either low molecular weight heparin or unfractionated standard heparin for thrombosis prophylaxis in patients with gynecologic malignancy. Annals of Hematology 1996;72 Suppl 1:A52.
16. Heilmann L, Tempelhoff GFV, Kirkpatrick C, Schneider DM, Hommel G, Pollow K. Comparison of unfractionated versus low molecular weight heparin for deep vein thrombosis prophylaxis during breast and pelvic cancer surgery: efficacy, safety, and follow-up. Clinical and Applied Thrombosis-Hemostasis 1998;4(4):268-73.
17. Kakkar VV, Boekl O, Boneu B, Bordnave L, Brehm OA. Efficacy and safety of LMWH and standard UFH for prophylaxis of postoperative venous thromboembolism. European multicenter trial. World Journal of Surgery 1997;21:2-9.
18. McLeod RS, Geerts WH, Sniderman KW. Subcutaneous heparin versus low-molecular-weight heparin as thromboprophylaxis in patients undergoing colorectal surgery. Annals of Surgery 2001;233:438-44.
19. Onarheim H, Lund T, Heimdal A, Arnesjo B. A low molecular weight heparin (KABI 2165) for prophylaxis of postoperative deep venous thrombosis. Acta Chirurgica Scandinavica 1986;152:593-6.
20. von Tempelhoff GF, Dietrich M, Niemann F, Schneider D, Hommel G, Heilmann L. Blood coagulation and thrombosis in patients with ovarian malignancy. Thrombosis and Haemostasis 1997;77(3):456-61.
21. von Tempelhoff GF, Harenberg J, Niemann F, Hommel G, Kirkpatrick CJ, Heilmann L. Effect of low molecular weight heparin (Certoparin) versus unfractionated heparin on cancer survival following breast and pelvic cancer surgery: a prospective randomized double-blind trial. International Journal of Oncology 2000;16(4):815-24.
22. Arbeit JM, Lowry SF, Line BR, Jones DC, Brennan MF. Deep venous thromboembolism in patients undergoing inguinal lymph node dissection for melanoma. Annals of Surgery 1981;194(5):648-55.
23. Attaran S, Somov P, Awad WI. Randomised high- and low-dose heparin prophylaxis in patients undergoing thoracotomy for benign and malignant disease: effect on thrombo-elastography. European Journal of Cardio-thoracic Surgery 2010;37:1384-90.
24. Azorin JF, Regnard JF, Dahan M, Pansart M. Efficacy and safety of fraxiparine in the prevention of thrombo-embolic events in lung cancer surgery. Annales de Cardiologie et d'Angeiologie 1997;46(5-6):341-7.
25. Bergqvist D, Burmark US, Frisell J, Hallbook T, Lindblad B, Risberg B, et al. Prospective double-blind comparison between Fragmin and conventional low-dose heparin: thromboprophylactic effect and bleeding complications. Haemostasis 1986;16 Suppl 2:11-8.
26. Bergqvist D, Matzsch T, Burmark US, Frisell J, Guilbaud O, Hallbook T, et al. Low molecular weight heparin given the evening before surgery compared with conventional low-dose heparin in prevention of thrombosis. British Journal of Surgery 1988;75:888-91.
27. Bergqvist D, Agnelli G, Cohen AT, Eldor A, Nilsson PE, Le Moigne-Amrani A, et al. Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer. New England Journal of Medicine 2002;346(13):975-80.
28. Bergqvist, D, G. Agnelli. The efficacy and safety of prolonged-one month-enoxaparin thromboprophylaxis for elective abdominal cancer surgery. The Enoxacan II study. Blood 2000;96(11 Part 1):654a.
29. Boneu B. An international multicentre study: Clivarin (R) in the prevention of venous thromboembolism in patients undergoing general surgery. Report of the International Clivarin (R) Assessment Group. Blood Coagulation & Fibrinolysis 1993;4:S21-2.
30. Borstad E, Urdal K, Handeland G, Abildgaard U. Comparison of low molecular weight heparin versus unfractionated heparin in gynaecological surgery. Acta Obstetricia et Gynecologica Scandinavica 1988;67:99-103.
31. Borstad E, Urdal K, Handeland G, Abildgaard. Comparison of low molecular weight heparin versus unfractionated heparin in gynecological surgery. Acta Obstetricia et Gynecologica Scandinavica 1992;71:471-5.
32. Bricchi M, Gemma M, Fiacchino F, Cerrato D, Ariano C. Prevention of thromboembolic disease with heparin-calcium in neurosurgery: evaluation of postoperative hemorrhagic complications. Minerva Anestesiologica 1991;57(10):1004-5.
33. Cade JF, Clegg EA, Westlake GW. Prophylaxis of venous thrombosis after major thoracic surgery. New Zealand Journal of Surgery 1983;53(4):301-4.
34. Caprini JA, Arcelus JI, Bautista E, Reyna JJ. Relative risk of bleeding when starting enoxaparin 2 or 12 hours before surgery for colorectal cancer. Phlebology 2003;18(3):147.
35. Clarke-Pearson DL, Coleman RE, Synan IS, Hinshaw W, Creasman W. Venous thromboembolism prophylaxis in gynecologic oncology: a prospective, controlled trial of low-dose heparin. American Journal of Obstetrics & Gynecology 1983;145:606-13.
36. Clarke-Pearson DL, DeLong ER, Synan IS, Creasman WT. Complications of low-dose heparin prophylaxis in gynecologic oncology surgery. Obstetrics and Gynecology 1984;64(5):689-94.
37. Clark-Pearson DL, DeLong E, Synan IS, Soper JT, Creasman WT, Coleman RE. A controlled trial of two low-dose heparin regimens for the prevention of postoperative deep vein thrombosis. Obstetrics & Gynecology 1990;75(4):684-9.
38. Clark-Pearson DL, DeLong E, Synan IS, Soper JT, Creasman WT, Coleman RE. A controlled trial of two low-dose heparin regimens for the prevention of postoperative deep vein thrombosis. Obstetrics & Gynecology 1990;75(4):684-9.
39. Dickinson LD, Miller LD, Patel CP, Gupta SK, et al. Enoxaparin increases the incidence of postoperative intracranial hemorrhage when initiated preoperatively for deep venous thrombosis prophylaxis in patients with brain tumors. Neurosurgery 1998;43:1074-81.
40. Gondret R, Dominici L, Angelard B, Dubos S, Alrawi S, Huet Y, et al. Safety of preoperative enoxaparin in head and neck cancer surgery. Head and Neck 1995;1:1-6.
41. Ho YH, Seow-Choen F, Leong A, Eu KW, Nyam D, Teoh MK. Randomized, controlled trial of low molecular weight heparin vs. no deep vein thrombosis prophylaxis for major colon and rectal surgery in Asian patients. Diseases of the Colon & Rectum 1999;42(2):196-202.
42. Kakkar VV, Murray WJ. Efficacy and safety of low-molecular-weight heparin (CY216) in preventing postoperative venous thrombo-embolism: a co-operative study. British Journal of Surgery 1985;72:786-91.
43. Kakkar VV, Stringer MD, Hedges AR, Parker CJ, Welzel D, Ward VP, et al. Fixed combinations of low-molecular weight or unfractionated heparin plus dihydroergotamine in the prevention of postoperative deep vein thrombosis. American Journal of Surgery 1989;157:413-8.
44. Kakkar VV, Balibrea J, Martinez-Gonzalez J, Prandoni P. Late breaking clinical trial: a randomised double blind trial to evaluate the efficacy and safety of prolonging the thromboprophylaxis with bemiparin in patients undergoing cancer abdominal or pelvic surgery (the CANBESURE study). International Society on Thrombosis and Haemostasis 2009;7 Suppl 2:1-1204.
45. Kakkar VV, Balibrea JL, Martínez-González J, Prandoni P, CANBESURE Study Group. Extended prophylaxis with bemiparin for the prevention of venous thromboembolism after abdominal or pelvic surgery for cancer: the CANBESURE randomized study. Journal of Thrombosis and Haemostasis 2010;8:1223-9.
46. Kakkar AK, Agnelli G, Fisher WD, George D, Mouret P, Lassen MR, et al. The ultra-low-molecular-weight heparin semuloparin for prevention of venous thromboembolism in patients undergoing major abdominal surgery. Blood 2010;116:188.
47. Liezorovicz A, Picolet H, Peyrieux JC, Boissel JP. Prevention of perioperative deep vein thrombosis in general surgery double blind study comparing two doses of logiparin and standard heparin. British Journal of Surgery 1991;78:412-6.
48. Limmer J, Ellbruck D, Muller H, Eisele E, Rist J, Schutze F, et al. Prospective randomized clinical study in general surgery comparing a new low molecular weight heparin with unfractionated heparin in the prevention of thrombosis. Clinical Investigator 1994;72:913-9.
49. Macdonald RL, Amidei C, Baron J, Weir B, Brown F, Erickson RK, et al. Randomized, pilot study of intermittent pneumatic compression devices plus dalteparin versus intermittent pneumatic compression devices plus heparin for prevention of venous thromboembolism in patients undergoing craniotomy. Surgical Neurology 2003;59:363.
50. Marassi A, Balzano G, Mari G, D'Angelo SV, Della Valle P, Di Carlo V, et al. Prevention of postoperative deep vein thrombosis in cancer patients. A randomized trial with low molecular weight heparin (CY 216). International Surgery 1993;78(2):166-70.
51. Maxwell GL, Synan I, Dodge R, Carroll B, Clarke-Pearson DL. Pneumatic compression versus low molecular weight heparin in gynecologic oncology surgery: a randomized trial. American College of Obstetricians and Gynecologists 2001;98(6):989-95.
52. Nurmohamed MT, Verhaeghe R, Haas S, Iriarte JA, Vogel G, van Rij AM, et al. A comparative trial of a low molecular weight heparin (enoxaparin) versus standard heparin for the prophylaxis of postoperative deep vein thrombosis in general surgery. American Journal of Surgery 1995;169(6):567-71.
53. Rasmussen M, Wille-Jorgensen P, Jorgensen LN, Nielsen JD, Horn A, et al. Prolonged thromboprophylaxis with low molecular weight heparin (dalteparin) following major abdominal surgery for malignancy. Blood 2003;102:186.
54. Sakon M, Kobayashi T, Shimazui T. Efficacy and safety of enoxaparin in Japanese patients undergoing curative abdominal or pelvic cancer surgery: results from a multicenter, randomized, open-label study. Thrombosis Research 2010;125:e65-70.
55. Samama M, Bernard P, Bonnardot JP, Combe-Tamzali S, Lanson Y, Tissot E. Low molecular weight heparin compared with unfractionated heparin in prevention of postoperative thrombosis. British Journal of Surgery 1988;75:128-31.
56. Shukla PJ, Siddachari R, Ahire S, Arya S, Ramani S, Barreto SG, et al. Postoperative deep vein thrombosis in patients with colorectal cancer. Indian Journal of Gastroenterology 2008;27(2):71-3.
57. Simonneau G, Laporte S, Mismetti P, Derlon A, Samii K, Samama CM, et al. A randomized study comparing the efficacy and safety of nadroparin 2850 IU (0.3 mL) vs. enoxaparin 4000 IU (40mg) in the prevention of venous thromboembolism after colorectal surgery for cancer. Journal of Thrombosis and Haemostasis 2006;4:1693-700.
58. Tang BQ, Guo W, Yang RL, Tang XD, Yan TQ, Tang S. Evaluation of efficacy and safety of rivaroxaban in the prevention of postoperative venous thromboembolism in adult patients with primary bone tumor undergoing knee operation. Zhonghua yi xue za zhi 2012;92(39):2768-771.
59. Ward B, Pradhan S. Comparison of low molecular weight heparin (Fragmin) with sodium heparin for prophylaxis against postoperative thrombosis in women undergoing major gynaecological surgery. Australian & New Zealand Journal of Obstetrics & Gynaecology 1998;38:91-2.
60. A Randomized, Controlled, Open Label Study of the Efficacy and Safety of the Low Molecular Weight Heparin (LMWH), LovenoxTM (Enoxaparin) Versus HeparinTM (Unfractionated Heparin) for Prevention of Venous Thromboembolism (VTE) in Gynecologic Oncology Patients. Ongoing study October 2009.
61. Akl EA, Labedi N, Terrenato I, Barba M, Sperati F, Sempos EV, et al. Low molecular weight heparin versus unfractionated heparin for perioperative thromboprophylaxis in patients with cancer. Cochrane Database Systematic Reviews 2011;9(11):1-54.
62. Akl EA, Johnston BC, Alonso-Coello P, Neumann I, Ebrahim S, Briel M, et al. Addressing dichotomous data for participants excluded from trial analysis: a guide for systematic reviewers. PLoS One 2013;8(2):e57132.
63. Barritt DW, Jordan SC. Anticoagulant drugs in the treatment of pulmonary embolism: a controlled trial. Lancet 1960;1:309-1312.
64. Borly L, Wille-Jorgensen P, Rasmussen MS. Systematic review of thromboprophylaxis in colorectal surgery. Colorectal Disease 2005;7:122-7.
65. Deeks JJ, Altman DG, Bradburn MJ. Statistical methods for examining heterogeneity and combining results from several studies in meta-analysis. In: Egger M, Davey Smith G, Altman DG editor(s). Systematic Reviews in Health Care: Meta-Analysis in Context. 2nd Edition. London: BMJ Publication Group, 2001.
66. Ebrahim S, Akl EA, Mustafa RA, Sun X, Walter SD, Heels-Ansdell D, et al. Addressing continuous data for participants excluded from trial analysis: a guide for systematic reviewers. Journal of Clinical Epidemiology 2013;66(9):1014-21.
67. Edmonds MJR, Crichton TJH, Runciman WB, Pradhan M. Evidence-based risk factors for postoperative deep vein thrombosis. ANZ Journal of Surgery 2004;74(12):1082-97.
68. Einstein MH, Pritts EA, Hartenbach EM. Venous thromboembolism prevention in gynecologic cancer surgery: a systematic review. Gynecologic Oncology 2007;105(3):813-9.
69. Flordal PA, Berggvist D, Burmark US, Ljungstrom KG, Torngren S. Risk factors for major thromboembolism and bleeding tendency after elective general surgical operations. European Journal of Surgery 1996;162:783-9.
70. Gallus AS. Prevention of post-operative deep leg vein thrombosis in patients with cancer. Thrombosis and Haemostasis 1997;78:126-32.
71. Gould MK, Garcia DA, Wren SM, Karanicolas PJ, Arcelus JI, Heit JA, et al. Prevention of VTE in nonorthopedic surgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012;141(2 Suppl):e227S-77S.
72. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analysis. BMJ 2003;327:557-60.
73. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2 [updated September 2009]. The Cochrane Collaboration, 2009. Available from www.cochrane-handbook.org.
74. Hirsh J. Low molecular weight heparin. Thrombosis and Haemostasis 1993;70(1):204-7.
75. Kakkar VV, Howe CT, Nicolaides AN, Renney JT, Clarke MB. Deep vein thrombosis of the leg. Is there a "high risk" group?. American Journal of Surgery 1970;120:527-30.
76. Levitan N, Dowlati A, Remick SC. Rates of initial and recurrent thromboembolic disease among patients with malignancy versus those without malignancy. Medicine 1999;78:285-91.
77. Martel N, Lee J, Wells PS. Risk for heparin-induced thrombocytopenia with unfractionated and low-molecular-weight heparin thromboprophylaxis. Blood 2005;106:2710-5.
78. Mismetti P, Laporte S, Darmon JY, Buchmuller A. Decousus H. Meta-analysis of low molecular weight heparin in the prevention of venous thromboembolism in general surgery. British Journal of Surgery 2001;88:913-30.
79. Morris TA, Castrejon S, Devendra G, Gamst AC. No difference in risk for thrombocytopenia during treatment of pulmonary embolism and deep venous thrombosis with either low-molecular-weight heparin or unfractionated heparin. Chest 2007;132:1131-9.
80. Rahr HB, Sorensen JV. Venous thromboembolism and cancer. Blood Coagulation & Fibrinolysis 1992;3:451-60.
81. Sorensen HT, Mellemkjaer L, Olsen JH, Baron JA. Prognosis of cancers associated with venous thromboembolism. New England Journal of Medicine 2000;343:1846-50.