Cochrane · systematic review · CD009447

Anticoagulation for perioperative thromboprophylaxis in people with cancer

Matar, CF, Kahale, LA, Hakoum, MB, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library

Gynaecological, Neuro-oncology and Orphan Cancer3 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
20
current version
GRADE rated
19
No studies
1
Included studies
NR
No studies 1 · 5%Ungraded 0 · 0%Very low 0 · 0%Low 9 · 45%Moderate 10 · 50%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 3 versions

LMWH prophylaxis compared to UFH prophylaxis in people with cancer without VTE undergoing a surgery

Population: People with cancer with perioperative thromboprophylaxis
13 questions
OutcomeEffectEvidenceStatus / GRADE
Mortality
LMWH prophylaxis vs UFH prophylaxis
RR 0.82 [0.63, 1.07]8 studies · 4260 participantsModerate
Downgraded: imprecision
Any PE
LMWH prophylaxis vs UFH prophylaxis
RR 0.49 [0.17, 1.47]14 studies · 5588 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Symptomatic DVT
LMWH prophylaxis vs UFH prophylaxis
RR 0.67 [0.27, 1.69]8 studies · 2250 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Symptomatic DVT measured as asymptomatic DVT
LMWH prophylaxis vs UFH prophylaxis
RR 0.86 [0.71, 1.05]12 studies · 4938 participantsLow
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Major bleeding
LMWH prophylaxis vs UFH prophylaxis
RR 1.01 [0.69, 1.48]9 studies · 3473 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Minor bleeding
LMWH prophylaxis vs UFH prophylaxis
RR 1.01 [0.76, 1.33]2 studies · 1194 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Wound hematoma
LMWH prophylaxis vs UFH prophylaxis
RR 0.7 [0.54, 0.92]6 studies · 2827 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Reoperation for bleeding
LMWH prophylaxis vs UFH prophylaxis
RR 0.93 [0.57, 1.5]4 studies · 1246 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Intraoperative transfusion
LMWH prophylaxis vs UFH prophylaxis
no estimate extracted2 studies · 737 participantsLow
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Postoperative transfusion
LMWH prophylaxis vs UFH prophylaxis
no estimate extracted2 studies · 734 participantsLow
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Intraoperative blood loss
LMWH prophylaxis vs UFH prophylaxis
no estimate extracted4 studies · 761 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Postoperative drain volume
LMWH prophylaxis vs UFH prophylaxis
no estimate extracted3 studies · 1459 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness
Thrombocytopenia
LMWH prophylaxis vs UFH prophylaxis
RR 3.07 [0.32, 29.33]2 studies · 683 participantsModerate
Downgraded: risk of bias, imprecision, inconsistency, indirectness

LMWH prophylaxis compared to fondaparinux prophylaxis in people with cancer without VTE undergoing a surgical procedure

Population: People with perioperative thromboprophylaxis in people with cancer
7 questions
OutcomeEffectEvidenceStatus / GRADE
Mortality ‐ not reported
LMWH prophylaxis vs fondaparinux prophylaxis
no estimate extractedNRNo studies
Any VTE
LMWH prophylaxis vs fondaparinux prophylaxis
RR 2.51 [0.89, 7.03]3 studies · 1806 participantsLow
Downgraded: imprecision, indirectness
Major Bleeding
LMWH prophylaxis vs fondaparinux prophylaxis
RR 0.74 [0.45, 1.23]3 studies · 2339 participantsLow
Downgraded: risk of bias, imprecision, indirectness
Minor Bleeding
LMWH prophylaxis vs fondaparinux prophylaxis
RR 0.83 [0.34, 2.05]2 studies · 398 participantsLow
Downgraded: risk of bias, imprecision, indirectness
Thrombocytopenia
LMWH prophylaxis vs fondaparinux prophylaxis
RR 0.35 [0.04, 3.3]1 study · 282 participantsLow
Downgraded: risk of bias, imprecision, indirectness
Any Pulmonary embolism
LMWH prophylaxis vs fondaparinux prophylaxis
RR 3.1 [0.13, 74.64]1 study · 116 participantsLow
Downgraded: risk of bias, imprecision, indirectness
Postoperative drain volume
LMWH prophylaxis vs fondaparinux prophylaxis
no estimate extracted1 study · 116 participantsLow
Downgraded: risk of bias, imprecision, indirectness