PO-37 - Optimization of the anticoagulant therapy in cancer patients

Introduction Thrombophilia is a serious risk factor for cancer patients. Aim To determine the optimal mode of appointment of antithrombotic prophylaxis in perioperative period in cancer patients. Materials and Methods The study involved 889 patients with gynecological cancer in the perioperative period. Group I - LMWH for 10 days before surgery 0.3 ml, cessation of therapy 24 hours before surgery, then 0.3 ml for 10 days postoperatively - 213 patients Group II - LMWH 24 hours before surgery, then 0.3 ml for 10 days in postoperative period - 212 Group III - LMWH 0.3 ml for 10 days postoperatively - 216 Group IV - unfractionated heparin 5000 IU 3 times a day for 10 days in the postoperative period – 248. Results Before surgery rate of subcompensated DIC was 18.5-50%. After surgery rate of subcompensated DIC has increased significantly to 52-75%. In group I, normal levels of DIC markers (TAT, PF4, F1 + 2) has been observed in 1-3 days. In group II normalization of DIC markers has been observed in 3-5 days. In group III DIC markers tended to normalize in 5-7 days. In group IV normalization of DIC markers has been detected only on the 7th day. D-dimer in some patients remained heightened for up to 10 days. In addition, 28 patients (13.7%) formed extensive bruising in the painful injection. Conclusions The proposed scheme prophylaxis: LMWH 10 days before surgery and cancel 24 hours prior to surgery, then 0.3 ml for 10 days in the postoperative period - virtually eliminates the risk of thrombosis and contributes normalization of DIC markers in 3 days. This scheme could be recommended for all cancer patients as a minimum program.