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. 2021 Sep 16;35(1):51-55.
doi: 10.1080/08998280.2021.1973340. eCollection 2022.

Meta-analysis of randomized controlled trials on primary ambulatory thromboprophylaxis in patients with nonpancreatic gastrointestinal cancers receiving chemotherapy

Thura Win Htut  1 , Kyaw Zin Thein  2   3 , Donald Paul Quick  4   5 , Thein Hlaing Oo  6
Affiliations

Meta-analysis of randomized controlled trials on primary ambulatory thromboprophylaxis in patients with nonpancreatic gastrointestinal cancers receiving chemotherapy

Thura Win Htut et al. Proc (Bayl Univ Med Cent). .

Abstract

Primary ambulatory thromboprophylaxis (PATP) in patients with solid malignancies is not routinely indicated. We performed a meta-analysis of randomized controlled trials (RCTs) to determine the benefit and risk of PATP in patients with nonpancreatic gastrointestinal cancers receiving chemotherapy. RCTs with venous thromboembolism (VTE) reduction as primary or secondary endpoints were included. A total of 1932 patients from subgroups of 3 RCTs were eligible. The VTE incidence was 1.26% and 2.55% in PATP and control arms, respectively (risk ratio 0.49; confidence interval 0.25 to 0.96; P = 0.04), with a number needed to treat of 78 to prevent one VTE event. In gastric and gastroesophageal junction cancer patients, the VTE incidence was 1.37% and 3.40% in PATP and control arms, respectively (risk ratio 0.40; confidence interval 0.13 to 1.24; P = 0.11). PATP should not be recommended in patients with nonpancreatic gastrointestinal cancers on chemotherapy.

Keywords: Ambulatory thromboprophylaxis; colorectal cancer; gastric cancer; gastroesophageal junctional cancer; meta-analysis; venous thromboembolism.

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Conflict of interest statement

Kyaw Zin Thein, Thura Win Htut, and Donald Quick declare no conflict of interest. Thein Hlaing Oo served on an advisory board for Bristol-Myers Squibb, not related to this manuscript.

Figures

Figure 1.
Figure 1.
Study flow diagram in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses statement (PRISMA).
Figure 2.
Figure 2.
Risk of bias summary.
Figure 3.
Figure 3.
(a) Pooled risk ratio and (b) risk difference for venous thromboembolism in ambulatory patients with nonpancreatic gastrointestinal cancers receiving thromboprophylaxis vs control.
Figure 4.
Figure 4.
Pooled risk ratio for venous thromboembolism in ambulatory patients with gastric and gastroesophageal junction cancers receiving thromboprophylaxis vs control.
See this image and copyright information in PMC

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