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?
Answer from: at Academic Institution
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...
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:
Fleming et al., ...