Background: The bidirectional relationship of cancer and hemostasis are well-known: they interact in a ”vicious cycle”, where cancers overexpress thrombin, which in turn promote both prothrombotic potential and tumor growth, invasion, and spread. Indeed, venous thromboembolism occurs frequently as a paraneoplastic event. Thus, anticoagulants could be accepted not only as a classic treatment for prevention thrombotic complications, but also as an anti-cancer therapy.

Aims: To estimate the rate of cancer recurrence in the group of patients receiving anticoagulant therapy and among patients not receiving anticoagulants.

Methods: In our case-control study 168 patients with advanced ovarian cancer were examined. In concordance with the identified risk of thrombosis (Khorana and Vienna CATS scale), as well as the presence of genetic thrombophilia (FV Leiden, Prothrombin mutation, MTHFRG mutation), the first group of patients (n=69) with a high risk of thrombosis received anticoagulant therapy (LMWH and NOAK), the second group (n=88) did not. Patients were under our supervision for 60-72 months.

Results: Our study showed that the group taking anticoagulants performed a significantly lower recurrence rate than the group of patients who did not receive regular anticoagulant therapy: 30.4% and 67% respectively. However, thrombotic complications, even with anticoagulant therapy, were more common in the first group – 15.9% versus 7.95%. in the second group. It is necessary to emphasize that in the first group were patients with a higher risk of thrombosis than in the second.

Conclusions: Available data confirm the role of the hemostatic system in the growth and metastasis of cancer, but we cannot confidently assert that anticoagulation therapy should be included in the secondary cancer prevention. The duration of study was sufficient, but the number of patients involved in the study needs to be expanded to draw fulfilled conclusions.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/anticoagulation-therapy-as-prevention-of-cancer-relapce/