Perioperative management of anticoagulation and antithrombotic therapy is challenging, and accurate knowledge and assessment of thromboembolic and bleeding risks will aid providers in making appropriate decisions regarding holding of anticoagulation, bridging anticoagulation, and post-procedural resumption of anticoagulation.
VTE is common among patients with cancer and represents an appreciable risk, with associated morbidity and mortality. Accurate VTE risk assessment is important in identifying appropriate candidates for VTE prophylaxis and at times can prevent unnecessary use of anticoagulants. Selecting a suitable regimen in these patients requires guidance from physicians with experience treating various oncology subpopulations.
Surveys suggest that patient and clinician education on cancer-associated VTE and safe use of DOACs is lacking, despite the fact that VTE is a major contributor to mortality among cancer patients.
Expanded indications for the use of the direct oral anticoagulants demand diligent monitoring. Health care professionals play a crucial role in the management of anticoagulation in cancer patients and anticoagulation monitoring clinics may need to rechannel resources to include these agents.
Expanded indications for the use of the direct oral anticoagulants demand diligent monitoring. Health care professionals play a crucial role in the management of anticoagulation in cancer patients and anticoagulation monitoring clinics may need to rechannel resources to include these agents.

Venous thromboembolism (VTE) is common in patients with cancer and increases morbidity and mortality. VTE prevention and treatment are more complex in patients with cancer.

This information was originally presented at the NCCN 23rd Annual Conference: Improving the Quality, Effectiveness, and Efficiency of Cancer Care held in Orlando, Florida, from March 22 - 24, 2018.

This information was originally presented at the NCCN 21st Annual Conference: Advancing the Standard of Cancer Care™ held in Hollywood, Florida, from March 31 – April 2, 2016.

The NCCN Guidelines for Cancer-Associated Venous Thromboembolic Disease outline strategies for treatment and prevention of venous thromboembolism (VTE) in adult patients with a diagnosis of cancer or for whom cancer is clinically suspected.

Venous thromboembolism (VTE) has serious consequences for patients with cancer, including mortality. VTE is preventable with appropriate thromboprophylaxis, but prior public health efforts have focused on prophylaxis in the inpatient setting.

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