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When, if ever, would you consider deep venous thrombosis prophylaxis for patients with advanced epithelial ovarian cancer undergoing neoadjuvant chemotherapy?

In your practice, what is the proportion of patients receiving neoadjuvant chemotherapy who are diagnosed with VTE? Does this differ from patients receiving adjuvant chemotherapy or chemotherapy for recurrent disease?
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Do you prescribe deep venous thrombosis prophylaxis for patients with advanced epithelial ovarian cancer undergoing neoadjuvant chemotherapy?

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2 Answers
Mednet Member
Mednet Member
Gynecologic Oncology · Wake Forest University School of Medicine
Answered on

The Khorana scoring system is a great tool when this question comes up. I use it for all my ovarian cancer patients who have measurable disease in the neoadjuvant and adjuvant settings. I re-evaluate their score every 3 months to ensure they are still candidates for VTE ppx.

Mulder et al., PMID 3060...

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Mednet Member
Mednet Member
Hematology · University of Texas M. D. Anderson Cancer Center
Answered on

We do not give primary ambulatory thromboprophylaxis in patients with ovarian cancer. Khorana scoring system does not work in ovarian cancer as evidenced by data from MD Anderson Cancer Center and others. We need a better scoring system for ovarian cancer.

References:

  1. Fleming et al., Gynecol Oncol...

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