{'fraction_non_alphanumeric': 0.035479632063074903, 'fraction_numerical': 0.016206745510293472, 'mean_word_length': 5.563218390804598, 'pattern_counts': {'":': 0, '<': 1, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Primary prevention of venous thromboembolic events (VTE) in cancer patients: An American survey study.

8086 Background: Optimal care of and research involving cancer patients at risk for and with documented VTE require insight into thrombosis risk factors plus risks and benefits of anticoagulation (AC). Formal quantification of oncologist attitudes towards VTE has been lacking.


METHODS
We performed a two-phase, web- and fax-based survey study of American oncologists, including 28 questions that asked respondents to quantify the "necessity" and "appropriateness" of VTE prophylaxis or treatment in several clinical scenarios. Mean responses provided assessment of group opinion.


RESULTS
In Phase I (n=507), 61% and 63% indicated regular prescription of inpatient and central line VTE prophylaxis, respectively; 39% believed that LMWHs can prolong cancer patient survival. Phase II (n=112 from 33 states) demographics: 63% private practice, 84% solid tumor focus, 79% Oncology board certified, 88% ASCO members. Respondents under-recognized known VTE risk factors (e.g. brain mets, antiangiogenesis drugs, and EPO) and high risk histologies (e.g. primary brain, lung, lymphoma, and ovary). Consensus on the necessity/appropriateness of VTE prophylaxis in cancer inpatients, outpatients, febrile neutropenia, advanced stage, and central lines was lacking. Prophylactic and treatment AC were deemed inappropriate in cancer patients without active bleeding and platelet counts < 50,000/μL. LMWHs were the preferred agents for active VTE prophylaxis in cancer inpatients and during febrile neutropenia; warfarin was preferred in those with advanced stage disease and central lines. 44% and 76% agreed that cancer patients require higher doses of thromboprophylaxis and are at higher risk for bleeding during thromboprophylaxis than non-cancer patients, respectively.


CONCLUSIONS
Under-recognition of prevalent risk factors and high risk histologies and fear of bleeding especially in thrombocytopenic patients may explain the underutilization of VTE prophylaxis by American oncologists. Formal investigation of the risks and benefits of anticoagulation in several oncology settings seems indicated in order to guide clinical practice and consensus building. [Table: see text].