• D Fagnani, R Franchi, C Porta, P Pugliese, K Borgonovo, A Bertolini, M Duro, A Ardizzoia, V Filipazzi, L Isa, C Vergani, M Milani, C Cimminiello, and POLONORD Group.
• Department of Medicine, Oncology Unit, Azienda Ospedaliera Ospedale Civile di Vimercate, Milan, Italy. danielefagnani@libero.it
• Ann. Oncol. 2007 Mar 1; 18 (3): 551-5.

BackgroundRecent guidelines do not recommend antithrombotic prophylaxis (AP) to prevent catheter-related thrombosis in cancer patients with a central line.Patients And MethodsThis study assessed the management of central lines in cancer patients, current attitude towards AP, catheter-related and systemic venous thromboses, and survival.ResultsOf 1410 patients enrolled, 1390 were seen at least once in the 6-month median follow-up. Continuous AP, mainly low-dose warfarin, was given to 451 (32.4%); they were older, with a more frequent history of venous thromboembolism (VTE), and more advanced cancer. There was no difference in catheter-related thrombosis in patients given AP or not (2.8% and 2.2%, odds ratio 1.29, 95% confidence interval 0.64-2.6). The median time to first catheter-related complication was 120 days. Systemic VTE including deep and superficial thromboses and pulmonary embolism, were less frequent with AP (4% versus 8.2%, P = 0.005). Mortality was also lower (25% versus 44%, P = 0.0001). Multiple logistic regression analysis found only advanced cancer and no AP significantly associated with mortality. No major bleeding was recorded with AP.ConclusionsCurrent AP schedules do not appear to prevent catheter-related thrombosis. Systemic VTE and mortality, however, appeared lower after prophylaxis.

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