Venous Thromboembolism in Cancer Patients Undergoing Major Abdominal Surgery: Prevention and Management

Table 6

Comparison of VTE pharmacoprophylactic recommendations laid down by ASCO, ACCP, NCCN, National Guideline Clearing House, and ESMO.

	Guideline last updated in	Drug				Duration
		Unfractionated heparin	Dalteparin	Enoxaparin	Fondaparinux
ASCO [127]	2007	5,000 U sc every 8 hours	5,000 U sc daily	40 mg sc daily	2.5 mg sc daily	Up to 7–10 days postop. Up to 4 weeks post op in high risk patients
ACCP [129]	2008	5,000 U sc every 8 hours	5,000 IU sc daily	40 mg sc daily	Not recommended	Up to 4 weeks after discharge
NCCN [205]	2011	5,000 U sc every 8 hours	5,000 IU sc daily	40 mg sc daily	2.5 mg sc daily	Up to 4 weeks postop
ESMO [128]	2011	5,000 U sc every 8 hours	5,000 U sc daily	40 mg sc daily	2.5 mg sc daily	Up to discharge or until ambulatory
National Guideline Clearinghouse [204]	2011	5,000 U sc every 12 hr postop	2,500 units sc 1-2 hr preop, then every 24 hr	40 mg sc 2 hr preop, then every 24 hr	Not recommended	Up to 4 weeks postop

VTE: venous thromboembolism, ASCO: American Society for Oncology, ACCP: American College of Chest Physicians, NCCN: National Comprehensive Cancer Network, ESMO: European Society Of Medical Oncology; LMWH: low molecular weight heparin, sc: subcutaneously, postop: postoperatively.