{
    "abstract": "Direct oral anticoagulants (DOACs) used as an alternative to low-molecular-weight heparin (LMWH) for thromboprophylaxis after cancer surgery for venous thromboembolic events (VTE) remains unclear. This study aimed to investigate the efficacy and safety of DOACs versus LMWH in these patients.\nA search of EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science was carried out and included all randomized controlled trials (RCTs) and observational studies that directly compared DOACs with LMWH for thromboprophylaxis in patients after cancer surgery through July 25, 2023. The primary efficacy and safety outcomes were VTE, major bleeding, and clinically relevant non-major bleeding (CRNMB) within 30\u00a0days of surgery. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB2) tool for RCTs and ROBINS-I tool for non-randomized studies. This study was registered in PROSPERO (CRD42023445386).\nWe retrieved 5149articles, selected 27 for eligibility, and included 10 studies (three RCTs and seven observational studies) encompassing 3054 patients who underwent postoperative thromboprophylaxis with DOACs (41%) or LMWH (59%). Compared to LMWH thromboprophylaxis, DOACs had a comparable risk of VTE (RR:0.69[95% CI:0.46-1.02], I\nDOACs are potentially effective alternatives to LMWH for thromboprophylaxis in patients undergoing cancer surgery, without increasing the risk of major bleeding events.",
    "authors": [
        {
            "affiliation": "Department of Pharmacy, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, Fujian, China.",
            "firstname": "Hong",
            "initials": "H",
            "lastname": "Zhou"
        },
        {
            "affiliation": "Department of Pharmacy, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, Fujian, China.",
            "firstname": "Ting-Ting",
            "initials": "TT",
            "lastname": "Chen"
        },
        {
            "affiliation": "Department of Pharmacy, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, Fujian, China.",
            "firstname": "Ling-Ling",
            "initials": "LL",
            "lastname": "Ye"
        },
        {
            "affiliation": "School of Medicine, Huaqiao University, Quanzhou, 362021, Fujian, China. majunjie3612@hqu.edu.cn.",
            "firstname": "Jun-Jie",
            "initials": "JJ",
            "lastname": "Ma"
        },
        {
            "affiliation": "Department of Pharmacy, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, Fujian, China. pollyzhang2006@126.com.",
            "firstname": "Jin-Hua",
            "initials": "JH",
            "lastname": "Zhang"
        }
    ],
    "conclusions": "DOACs are potentially effective alternatives to LMWH for thromboprophylaxis in patients undergoing cancer surgery, without increasing the risk of major bleeding events.",
    "copyrights": "\u00a9 2024. The Author(s).",
    "doi": "10.1186/s12957-024-03341-5\n10.1016/j.blre.2018.06.002\n10.1001/jama.293.6.715\n10.1097/SLA.0b013e318195c50c\n10.1186/s12959-023-00530-2\n10.1182/blood.2022015796\n10.1200/JCO.2018.78.8034\n10.1002/rth2.12002\n10.1111/j.1538-7836.2005.01204.x\n10.1016/j.thromres.2021.06.010\n10.1016/j.ygyno.2020.06.505\n10.1001/jama.2023.7843\n10.1016/j.chest.2021.09.037\n10.1111/jth.14662\n10.1056/NEJMoa1915103\n10.1056/NEJMoa1711948\n10.1200/JCO.23.00294\n10.1016/j.annonc.2022.12.014\n10.1016/S1470-2045(22)00160-7\n10.1182/bloodadvances.2020003442\n10.1001/jamanetworkopen.2020.7410\n10.1177/10760296221132556\n10.1016/j.ijsu.2021.105906\n10.1136/bmj.j4008\n10.1111/jth.13140\n10.1016/0197-2456(86)90046-2\n10.1136/bmj.327.7414.557\n10.1136/bmj.315.7109.629\n10.1002/cl2.1230\n10.1002/ajh.26945\n10.1016/j.ygyno.2018.04.453\n10.1016/j.urology.2021.04.054\n10.1007/s11605-018-3936-1\n10.1111/bju.16036\n10.1016/j.ygyno.2023.02.012\n10.1016/S0090-8258(21)01105-7\n10.1097/JU.0000000000002788\n10.1002/jrsm.1411\n10.1097/SLA.0b013e31821b98da\n10.1001/jamasurg.2013.3172\n10.1016/j.jtcvs.2022.06.016\n10.1016/j.thromres.2018.02.144\n10.1093/annonc/mdw371.87\n10.1016/j.thromres.2020.06.025\n10.1055/s-0040-1712098\n10.1093/ehjcvp/pvaa067",
    "journal": "World journal of surgical oncology",
    "keywords": [
        "Cancer surgery",
        "Direct oral anticoagulants",
        "Low-molecular-weight heparin",
        "Meta-analysis",
        "Thromboprophylaxis"
    ],
    "methods": null,
    "publication_date": "2024-02-26",
    "pubmed_id": "38403630\n30262170\n15701913\n19247020\n37559115\n35580191\n29746227\n30046670\n15842354\n31449321\n34175749\n32641236\n37266947\n34627853\n31630479\n32223112\n29231094\n37075273\n36638869\n35772465\n33570602\n32589230\n36474344\n33789826\n28935701\n26764429\n31462531\n27733354\n3802833\n12958120\n9310563\n36911350\n37139837\n34171347\n30187331\n37186173\n36905769\n36082549\n32336025\n21527843\n24197279\n35953309\n29506866\n32788122\n32365386\n32556105",
    "results": "We retrieved 5149articles, selected 27 for eligibility, and included 10 studies (three RCTs and seven observational studies) encompassing 3054 patients who underwent postoperative thromboprophylaxis with DOACs (41%) or LMWH (59%). Compared to LMWH thromboprophylaxis, DOACs had a comparable risk of VTE (RR:0.69[95% CI:0.46-1.02], I",
    "title": "Efficacy and safety of direct oral anticoagulants versus low-molecular-weight heparin for thromboprophylaxis after cancer surgery: a systematic review and meta-analysis.",
    "xml": "<Element 'PubmedArticle' at 0x788506d03fb0>"
}