Background: Venous thromboembolism (VTE) is associated with a significant risk of morbidity and potentially preventable death in surgical patients. However, it is widely believed that the incidence of VTE in Asian population is less frequently observed than the Western population. Therefore, routine chemoprophylaxis may not be necessary.
Aims: This systematic review aims to evaluate the incidence of venous thromboembolism (VTE) in colorectal cancer (CRC) surgery patients in the Asian population with and without the use of chemoprophylaxis. The secondary aim is to assess potential bleeding complications associated with it.
Methods: Studies published up to June 30 2020 were searched from PubMed, Embass, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled trials and google scholar. Articles were found using the keywords: Asia, Asian, venous thromboembolism, deep vein thrombosis, pulmonary embolism, colorectal surgery with the inclusion criteria:
1) all randomized controlled trials (RCT), case-control and cohort studies,
2) population studied was primarily Asian or the study was conducted in an Asian country,
3) patients must undergo primary resection for the colorectal cancer,
4) studies reported incidence of DVT/PE.
Results: 12 studies (3 RCTs and 9 observational cohort studies) encompassing 8107 patients were included. The distribution of the population was in the following numbers: Korean (n=4162, 51.3%), Japanese (n=2327, 28.7%), Chinese (n=1519, 18.7%) and Indian (n=99, 1.2%). Overall incidence of VTE was 1.9%. Addition of chemoprophylaxis did not result in a significant decreased in incidence of VTE (0.9% versus 3.2%, p = 0.19), but associated with an increased in incidence of bleeding complications (0.8% versus 0.6%, p=0.004.)
Conclusions: There may not be additional benefit in the use of chemoprophylaxis for VTE prevention for colorectal cancer surgery in Asian population. The decision to introduce chemoprophylaxis should be individualized and also take into account the significant bleeding risks.
To cite this abstract in AMA style:Tan SJJ, Chok AY, Ng YY, Seow-En I, Sultana R, Allen JC, Tan EKW, RM. A Systematic Review and Meta-analysis on the Use of Chemoprophylaxis in the Prevention of Venous Thromboembolism in Colorectal Cancer Surgery in Asian Population [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/a-systematic-review-and-meta-analysis-on-the-use-of-chemoprophylaxis-in-the-prevention-of-venous-thromboembolism-in-colorectal-cancer-surgery-in-asian-population/. Accessed September 21, 2023.
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