SOP: Die tumorassoziierte Thromboembolie am Beispiel des Ovarialkarzinoms

Venöse Thromboembolien gehören zu den häufigen Komplikationen bei Tumorpatienten. Diese Erkrankungen können nicht nur prognostisch ungünstig sein, sie sind auch mit einer erhöhten Morbidität und Mortalität verbunden. Mit der Diagnostik und den Optionen einer gezielten Therapie sollte der behandelnde Arzt vertraut sein. Dieser Beitrag gibt einen Überblick sowie Handlungsempfehlungen zu tumorassoziierten Thromboembolien.

Schlüsselwörter

Ovarialkarzinom - Thromboembolie - VTE - Tumorpatienten

Publication History

Article published online:
04 September 2025

• Literatur

• 1 Mulder FI, Horváth-Puhó E, van Es N. et al. Venous thromboembolism in cancer patients: a population-based cohort study. Blood 2021; 137: 1959-1969
• 2 Timp JF, Braekkan SK, Versteeg HH. et al. Epidemiology of cancer-associated venous thrombosis. Blood 2013; 122: 1712-1723
• 3 Khorana AA, Francis CW, Culakova E. et al. Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy. J Thromb Haemost 2007; 5: 632-634
• 4 Khorana AA, Francis CW, Culakova E. et al. Frequency, risk factors, and trends for venous thromboembolism among hospitalized cancer patients. Cancer 2007; 110: 2339-2346
• 5 Ay C, Vormittag R, Dunkler D. et al. D-dimer and prothrombin fragment 1 + 2 predict venous thromboembolism in patients with cancer: results from the Vienna Cancer and Thrombosis Study. J Clin Oncol 2009; 27: 4124-4129
• 6 Cronin-Fenton DP, Søndergaard F, Pedersen LA. et al. Hospitalisation for venous thromboembolism in cancer patients and the general population: a population-based cohort study in Denmark, 1997–2006. Br J Cancer 2010; 103: 947-953
• 7 Nalluri SR, Chu D, Keresztes R. et al. Risk of venous thromboembolism with the angiogenesis inhibitor bevacizumab in cancer patients: a meta-analysis. JAMA 2008; 300: 2277-2285
• 8 Falanga A, Marchetti M, Vignoli A. Coagulation and cancer: biological and clinical aspects. J Thromb Haemostasis 2013; 11: 223-233
• 9 Cohen A, Lim CS, Davies AH. Venous thromboembolism in gynecological malignancy. Int J Gynecol Cancer 2017; 27: 1970-1978
• 10 Hisada Y, Mackman N. Cancer-associated pathways and biomarkers of venous thrombosis. Blood 2017; 130: 1499-1506
• 11 Davis AN, Afshar-Kharghan V, Sood AK. Platelet effects on ovarian cancer. Semin Oncol 2014; 41: 378-384
• 12 Meyer G, Planquette B. Incidental venous thromboembolism, detected by chance, but still venous thromboembolism. Eur Respir J 2020; 55: 2000028
• 13 Carrier M, Lee AYY, Bates SM. et al. Accuracy and usefulness of a clinical prediction rule and D-dimer testing in excluding deep vein thrombosis in cancer patients. Thromb Res 2008; 123: 177-183
• 14 Wells PS, Hirsh J, Anderson DR. et al. Accuracy of clinical assessment of deep vein thrombosis. Lancet 1995; 345: 1326-1330
• 15 Wells PS, Ginsberg JS, Anderson DR. et al. Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med 1998; 129: 997-1005
• 16 AWMF. S2k-Leitlinie „Diagnostik und Therapie der Venenthrombose und Lungenembolie“. AWMF-Register Nr. 065/002. 2023 Accessed January 08, 2025 at: https://register.awmf.org/assets/guidelines/065-002l_S2k_Venenthrombose-Lungenembolie_2023-09.pdf
• 17 Carrier M, Cameron C, Delluc A. et al. Efficacy and safety of anticoagulant therapy for the treatment of acute cancer-associated thrombosis: a systematic review and meta-analysis. Thromb Res 2014; 134: 1214-1219
• 18 Lee AYY, Levine MN, Baker RI. et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med 2003; 349: 146-153
• 19 Mulder FI, Bosch FTM, Young AM. et al. Direct oral anticoagulants for cancer-associated venous thromboembolism: a systematic review and meta-analysis. Blood 2020; 136: 1433-1441