{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:04:01Z","timestamp":1788545041374,"version":"build-2803163510"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The risk of venous thromboembolism (VTE) is high after cancer surgery and is reduced by antithrombotic prophylaxis.<\/jats:p>\n                  <jats:p>We conducted a systematic review and network meta-analysis to evaluate the effectiveness and safety of direct oral anticoagulants (DOACs) for VTE prophylaxis after cancer surgery. The primary study outcome was 30-day VTE after surgery. Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated.<\/jats:p>\n                  <jats:p>Five randomized controlled trials (RCTs; two gynecological, one abdominal, one neurosurgical, and one thoracic; 1,694 patients) and seven observational studies (three urological, two abdominal, and two gynecological; 2,042 patients) were included. DOACs reduced the incidence of 30-day (OR 0.52, 95% CI 0.27-0.98, I2 22.7%) and 90-day VTE (OR 0.51, 95% CI 0.28-0.92, I2 0%) compared to LMWH. No difference was observed between DOACs and LMWH in 30 and 90-day bleeding outcomes. In random effect analyses, apixaban (OR 0.31, 95% CI 0.11-0.84) and not rivaroxaban reduced the risk of 30 day-VTE compared to LMWH (OR 0.69, 95% CI 0.35-1.34) without increasing the risk of bleeding at 30 or 90 days. No difference in the risk of VTE or bleeding was observed between DOACs and placebo\/no treatment, but these analyses were probably underpowered. Subgroup analyses were conducted on LMWH pre-treatment, extended prophylaxis, duration of surgery, and type of surgery.<\/jats:p>\n                  <jats:p>Our study supports apixaban and rivaroxaban as promising alternatives to LMWH in post-operative prophylaxis of VTE after cancer surgery. Further high-quality data are needed in specific surgical settings.<\/jats:p>","DOI":"10.1055\/a-2628-3967","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T20:13:07Z","timestamp":1749154387000},"page":"429-438","source":"Crossref","is-referenced-by-count":3,"title":["Direct Oral Anticoagulants for Prevention of Venous Thromboembolism after Cancer-Related Surgery: Systematic Review and Network Meta-Analysis"],"prefix":"10.1055","volume":"126","author":[{"given":"Gerardo N.","family":"Pititto","sequence":"first","affiliation":[{"name":"Internal Medicine Residency Program, School of Medicine, University of Insubria, Varese and Como, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Maraziti","sequence":"first","affiliation":[{"name":"Internal, Vascular and Emergency Medicine - Stroke Unit, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5705-2897","authenticated-orcid":false,"given":"Alessandro","family":"Squizzato","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Research Center on Thromboembolic Disorders and Antithrombotic Therapies, University of Insubria - ASST Lariana, Como, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Becattini","sequence":"additional","affiliation":[{"name":"Internal, Vascular and Emergency Medicine - Stroke Unit, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1634\/theoncologist.2016-0214","article-title":"Cancer and venous thromboembolic disease: a 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Agnelli","year":"2006","journal-title":"Ann Surg"},{"issue":"04","key":"ref5","first-page":"2919","article-title":"Incidence, risk factors, and management of bleeding in patients receiving anticoagulants for the treatment of cancer-associated thrombosis","volume":"30","author":"C Frere","year":"2022","journal-title":"Support Care Cancer"},{"issue":"13","key":"ref6","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1056\/NEJMoa012385","article-title":"Duration of prophylaxis against venous thromboembolism with enoxaparin after surgery for cancer","volume":"346","author":"D Bergqvist","year":"2002","journal-title":"N Engl J Med"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1111\/j.1538-7836.2010.03892.x","article-title":"Extended prophylaxis with bemiparin for the prevention of venous thromboembolism after abdominal or pelvic surgery for cancer: the CANBESURE randomized study","volume":"8","author":"V V 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