The Effects of Unfractionated Heparin on Survival in Patients with Malignancy – A Systematic Review

Susanne M. Smorenburg; Rohan J. K. Hettiarachchi; Roel Vink; Harry R. Büller

doi:10.1055/s-0037-1614885

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1999; 82(06): 1600-1604
DOI: 10.1055/s-0037-1614885

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Schattauer GmbH

The Effects of Unfractionated Heparin on Survival in Patients with Malignancy – A Systematic Review

Susanne M. Smorenburg

¹From the Departments of Vascular Medicine, University of Amsterdam, Amsterdam, The Netherlands

,

Rohan J. K. Hettiarachchi

²Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

,

Roel Vink

¹From the Departments of Vascular Medicine, University of Amsterdam, Amsterdam, The Netherlands

,

Harry R. Büller

¹From the Departments of Vascular Medicine, University of Amsterdam, Amsterdam, The Netherlands

› Author Affiliations

Abstract

Summary

Clinical and experimental studies have suggested that unfractionated heparin (UFH) effects malignancy progression. We reviewed all published clinical reports concerning the effects of UFH, as compared to no treatment on survival of cancer patients. Studies were classified on methodological strength and subdivided as to whether therapeutic or prophylactic dosages of UFH were used. Mortality rates after 3 years were extracted or calculated. One randomized study that evaluated the use of UFH in therapeutic dosages in patients with small cell lung carcinoma reported on an improved survival (odds ratio (OR) 0.64; 95% confidence interval (CI): 0.25 to 1.62). A detrimental effect was observed in 2 randomized studies which investigated the effects of intraportal UFH treatment in a prophylactic dose after surgery for gastrointestinal cancer (OR 1.66; 95% CI: 1.02 to 2.71). In contrast, level 2 studies in which either therapeutic or prophylactic dosages of UFH on mortality of patients with gastrointestinal cancer were evaluated, showed OR of 0.58 (95% CI; 0.11-3.13) and 0.65 (95% CI 0.51 to 0.84), respectively. We conclude that there is no convincing evidence of either positively or negatively effects of UFH on survival of patients with malignancy.

Harry R. Büller is an Established Investigator of the Dutch Heart Foundation

Key Words

Unfractionated heparin - cancer - survival - meta analysis

Full Text

References

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